Jefferson Health Plans Provider Directory FHIR API

openapi: 3.0.3
info:
  title: Jefferson Health Plans Provider Directory FHIR API
  description: >-
    OpenAPI surface for the Jefferson Health Plans (formerly Health Partners
    Plans) Provider Directory FHIR API — a public HL7 FHIR Release 4.0.1
    endpoint powered by Smile CDR 2025.02.R04 that surfaces JHP's network
    of in-network practitioners, organizations, locations, healthcare
    services, and insurance plans for the CMS Interoperability and Patient
    Access Provider Directory requirement. Aligned with the HL7 Da Vinci
    Payer Data Exchange Plan-Net implementation guide.
  version: '4.0.1'
  contact:
    name: Jefferson Health Plans Interoperability
    url: https://www.jeffersonhealthplans.com/home/about-us/interoperability/api-tools/
  license:
    name: HL7 FHIR License
    url: https://www.hl7.org/fhir/license.html
servers:
- url: https://providerfhirapi.healthpartnersplans.com
  description: Jefferson Health Plans Provider Directory FHIR R4 production endpoint
externalDocs:
  description: HL7 Da Vinci PDEX Plan-Net Implementation Guide
  url: https://build.fhir.org/ig/HL7/davinci-pdex-plan-net/
tags:
- name: Metadata
  description: FHIR conformance discovery.
- name: Practitioner
  description: A person who is directly or indirectly involved in the provisioning of healthcare.
- name: Practitioner Role
  description: A specific set of roles a practitioner may perform at an organization for a period of time.
- name: Organization
  description: A formally or informally recognized grouping of people or organizations.
- name: Location
  description: Details and position information for a physical place.
- name: Healthcare Service
  description: The details of a healthcare service available at a location.
- name: Insurance Plan
  description: Details of a Health Insurance product/plan provided by an organization.
- name: Endpoint
  description: The technical details of an endpoint that can be used for electronic services.
paths:
  /metadata:
    get:
      tags:
      - Metadata
      summary: Get FHIR Capability Statement
      description: Returns the FHIR CapabilityStatement describing the Provider Directory's supported resources and search parameters.
      operationId: getMetadata
      responses:
        '200':
          description: FHIR CapabilityStatement resource
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/CapabilityStatement'
  /Practitioner/{id}:
    get:
      tags:
      - Practitioner
      summary: Read Practitioner By Id
      operationId: readPractitioner
      parameters:
      - $ref: '#/components/parameters/ResourceId'
      responses:
        '200':
          description: Practitioner resource
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Practitioner'
  /Practitioner:
    get:
      tags:
      - Practitioner
      summary: Search Practitioner
      description: Search Practitioner resources by name, family, given, or resource id.
      operationId: searchPractitioner
      parameters:
      - name: name
        in: query
        description: Practitioner name.
        schema:
          type: string
      - name: family
        in: query
        description: Family name.
        schema:
          type: string
      - name: given
        in: query
        description: Given name.
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of Practitioner resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /PractitionerRole:
    get:
      tags:
      - Practitioner Role
      summary: Search Practitioner Role
      description: Search PractitionerRole resources by specialty, role, network, organization, practitioner, service, location, or endpoint.
      operationId: searchPractitionerRole
      parameters:
      - name: specialty
        in: query
        schema:
          type: string
      - name: role
        in: query
        schema:
          type: string
      - name: network
        in: query
        schema:
          type: string
      - name: organization
        in: query
        schema:
          type: string
      - name: practitioner
        in: query
        schema:
          type: string
      - name: service
        in: query
        schema:
          type: string
      - name: location
        in: query
        schema:
          type: string
      - name: endpoint
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of PractitionerRole resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /Organization/{id}:
    get:
      tags:
      - Organization
      summary: Read Organization By Id
      operationId: readOrganization
      parameters:
      - $ref: '#/components/parameters/ResourceId'
      responses:
        '200':
          description: Organization resource
          content:
            application/fhir+json:
              schema:
                type: object
  /Organization:
    get:
      tags:
      - Organization
      summary: Search Organization
      description: Search Organization resources by type, endpoint, coverage area, name, address, or id.
      operationId: searchOrganization
      parameters:
      - name: type
        in: query
        schema:
          type: string
      - name: endpoint
        in: query
        schema:
          type: string
      - name: coverage-area
        in: query
        schema:
          type: string
      - name: name
        in: query
        schema:
          type: string
      - name: address
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of Organization resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /Location:
    get:
      tags:
      - Location
      summary: Search Location
      description: Search Location resources by address components, type, endpoint, organization, or hierarchy.
      operationId: searchLocation
      parameters:
      - name: address-state
        in: query
        schema:
          type: string
      - name: address-city
        in: query
        schema:
          type: string
      - name: address-postalcode
        in: query
        schema:
          type: string
      - name: type
        in: query
        schema:
          type: string
      - name: endpoint
        in: query
        schema:
          type: string
      - name: organization
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of Location resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /HealthcareService:
    get:
      tags:
      - Healthcare Service
      summary: Search Healthcare Service
      description: Search HealthcareService resources by specialty, service category/type, coverage area, organization, name, location, or id.
      operationId: searchHealthcareService
      parameters:
      - name: specialty
        in: query
        schema:
          type: string
      - name: service-category
        in: query
        schema:
          type: string
      - name: service-type
        in: query
        schema:
          type: string
      - name: coverage-area
        in: query
        schema:
          type: string
      - name: organization
        in: query
        schema:
          type: string
      - name: name
        in: query
        schema:
          type: string
      - name: location
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of HealthcareService resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /InsurancePlan:
    get:
      tags:
      - Insurance Plan
      summary: Search Insurance Plan
      description: Search InsurancePlan resources by plan type, coverage area, identifier, administered-by organization, or name.
      operationId: searchInsurancePlan
      parameters:
      - name: type
        in: query
        schema:
          type: string
      - name: coverage-area
        in: query
        schema:
          type: string
      - name: identifier
        in: query
        schema:
          type: string
      - name: administered-by
        in: query
        schema:
          type: string
      - name: name
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of InsurancePlan resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /Endpoint:
    get:
      tags:
      - Endpoint
      summary: Search Endpoint
      description: Search Endpoint resources by managing organization or resource id.
      operationId: searchEndpoint
      parameters:
      - name: organization
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/Count'
      responses:
        '200':
          description: Bundle of Endpoint resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
components:
  parameters:
    ResourceId:
      name: id
      in: path
      required: true
      description: FHIR logical id of the resource.
      schema:
        type: string
    Count:
      name: _count
      in: query
      description: Number of resources to return per page.
      schema:
        type: integer
        minimum: 1
        maximum: 1000
  schemas:
    CapabilityStatement:
      type: object
      description: HL7 FHIR CapabilityStatement resource.
      properties:
        resourceType:
          type: string
          enum: [CapabilityStatement]
        fhirVersion:
          type: string
          example: '4.0.1'
        software:
          type: object
        rest:
          type: array
          items:
            type: object
    Bundle:
      type: object
      description: HL7 FHIR Bundle resource (searchset).
      properties:
        resourceType:
          type: string
          enum: [Bundle]
        type:
          type: string
          enum: [searchset]
        total:
          type: integer
        entry:
          type: array
          items:
            type: object
    Practitioner:
      type: object
      properties:
        resourceType:
          type: string
          enum: [Practitioner]
        id:
          type: string
        identifier:
          type: array
          items:
            type: object
        name:
          type: array
          items:
            type: object