Interoperability Provider Directory Provider

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.

Provider-related resources include insurance plan information , locations, healthcare services, and networks required to delivery provider directory information.


Provider directory information also includes pharmacies. There are nine provider resources that conform to the HL7 FHIR standards.

Quality Information

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.

Developer Resources

Interoperability Provider Directory API Provider


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