Provider directory API access guide

Overview

The provider directory is an open access and public-facing API to make provider directory information available. This API does not require any authentication for any user.

This documentation presumes that anyone accessing the API is familiar with the implementation guide for provider directory, FHIR US DAVINCI-PDEX v4.0.1.

URL (Production) – https://providerdirectory-api.vibrahealthplan.com/r4

/Profile -

  • /Practitioner
  • /PractitionerRole
  • /Location
  • /Organization
  • /OrganizationAffiliation
  • /InsurancePlan
  • /HealthcareService
  • /metadata

Practitioner

  • Search practitioner by family name
  • Search practitioner by family name and given name
  • Search practitioner by given name
  • Search practitioner by name
  • Search practitioner by name within a date range

Practitioner role

  • Search practitioner role by role
  • Search practitioner role by specialty
  • Search practitioner role by role and specialty
  • Search practitioner role by role and updated date

Location

  • Search location by city
  • Search location by a list of cities
  • Search location by state
  • Search location by postal code
  • Search location by address
  • Search location by type
  • Search location by address and updated date

Organization

  • Search organization by name
  • Search organization by address
  • Search organization by type
  • Search organization by name and type
  • Search organization by name and updated date

Organization affiliation

  • Search organization affiliation by role
  • Search organization affiliation by a list of roles
  • Search organization affiliation by specialty
  • Search organization affiliation by role and specialty
  • Search organization affiliation by role and updated date

Network (Profile: organization)

  • Search network by name
  • Search network by type
  • Search network by address
  • Search network by name and updated date

Insurance plan

  • Search insurance plan by name
  • Search insurance plan by a list of names
  • Search insurance plan by plan type
  • Search insurance plan by type
  • Search insurance plan by name and type
  • Search insurance plan by name and updated date

Healthcare services

  • Search healthcare service by name
  • Search healthcare services by the list of names
  • Search healthcare services by service category
  • Search healthcare service by service type
  • Search healthcare service by specialty
  • Search healthcare services by specialty, service category, and service type
  • Search healthcare service by name and updated date

The provider directory is an open access API and it does not restrict anyone from accessing the information. However, we do monitor the pattern of the requests and can potentially block IP addresses if any threat is perceived from those requests.

Please find the DaVinci PDEX Plan Net capability statement.

Conformance expectation - SHALL

Resources

Description

CMS Interoperability and Patient Access Final Rule

Interoperability and Patient Access Final Rule (May 1, 2020) Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges, and Health Care Providers (85 Fed. Reg. 25510)

21st Century Cures Act

Interoperability, Information Blocking, and the ONC Health IT Certification Program.

FHIR US DAVINCI-PDEX v4.0.1

This implementation guide defines a FHIR interface to a health insurer’s insurance plans, their associated networks, and the organizations and providers that participate in these networks.

Updated October 1, 2021
H9408_WBST22_M