Interoperability Provider Directory API Provider v1

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As part of the CMS Interoperability and Patient Access final rule (CMS-9115-F), payers must make provider information available. These APIs are required to retrieve the provider information directly.

There are nine provider resources that conform to the HL7 FHIR standards. These resources provide information on providers and pharmacies within the specific payer's network. Note that four of these resources also appear in the Clinical section.

More details on this API can be found in the Capability Statement API as well as in the swagger document.

APIs in this category follow the PDEX Payer Network Implementation Guide v1.0.0 found at