Peak Health · Medicare Advantage · Contract H8947
Provider Directory API
A public FHIR R4 API for the Peak Health Medicare Advantage provider network, published under the CMS Interoperability and Patient Access final rule (CMS-9115-F). No registration, key, or authentication is required — every example on this page is a working link.
Base URL
The base URL (and /metadata) returns the server’s CapabilityStatement, which is the machine-readable version of this page: supported resource types, search parameters, and includes. Responses are JSON (application/fhir+json), FHIR version 4.0.1, conforming to the Da Vinci PDex Plan-Net Implementation Guide v1.2.0.
Authentication
None. Per CMS-9115-F, the provider directory API is open to the public without authentication or authorization. Please identify your application with a descriptive User-Agent header and cache responses where practical.
Resource types
The directory publishes seven resource types covering the CY2027 H8947 plan network:
| Resource | Contents | Search parameters |
|---|---|---|
Practitioner |
Individual providers: name, NPI, gender, languages | _id, name, family, given, specialty |
PractitionerRole |
A practitioner’s participation in a network: specialty, accepting-new-patients status, phone, locations | _id, specialty, practitioner, network |
Location |
Practice locations: address, phone, coordinates | _id, address, address-city, address-state, address-postalcode |
Organization |
Facilities, networks, and the payer | _id, name, type |
OrganizationAffiliation |
Facility participation in networks | _id, specialty, network |
InsurancePlan |
The H8947 plans and their networks | _id, identifier |
HealthcareService |
Services offered at facilities (dialysis, imaging, home health, DME, …) | _id |
PractitionerRole supports _include for practitioner, location, and network; Practitioner supports _revinclude=PractitionerRole:practitioner; OrganizationAffiliation supports _include for organization, location, and network. Specialty parameters take NUCC provider taxonomy codes.
Paging
Search results are FHIR searchset Bundles. By default a search returns the complete result set; pass _count and _offset to page, and follow the Bundle’s next link. Bundle.total always reports the full match count.
Errors and exceptions
Errors are returned as FHIR OperationOutcome resources with an appropriate HTTP status code:
| Condition | Response |
|---|---|
| Unsupported resource type | 404 with an OperationOutcome (issue.code = not-found) |
| Unknown resource id | 404 with an OperationOutcome (issue.code = not-found) |
| Unrecognized search parameter | Ignored; the search executes on the recognized parameters |
Malformed _count / _offset |
The parameter falls back to its default (full result set, offset 0) |
A search that matches nothing is not an error: it returns a 200 with an empty Bundle and total: 0.
Examples
Cardiologists accepting the directory’s networks
Open in a browser — no key needed.
Practitioners by name
Locations in a city
The plans under contract H8947
Read a single resource
Machine-readable plan files (MPF)
The CMS machine-readable provider directory files for contract H8947 (CY2027) are published alongside this API:
The index lists the current data files. Both the MPF files and this API are generated from the same provider roster.
Data and terms
- The directory contains public provider information only: names, NPIs, specialties, practice addresses and phone numbers, network participation, and accepting-new-patients status. It contains no member, claims, or clinical data.
- Data is refreshed as the provider roster changes; each resource carries
meta.lastUpdated. - The API is provided for use in patient-facing and research applications consistent with the CMS Interoperability and Patient Access final rule. Abusive traffic may be rate-limited.
Support
Members looking for a doctor should use the Find a Provider directory or call Member Services at 1-866-850-2603 (TTY 711).
Developers: report API issues or ask integration questions at [email protected].