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Provider Directory API

Plan-Net PractitionerRole

The PractitionerRole resource profile describes details about a provider, which can be a practitioner or an organization.

  • When the provider is a practitioner, there may be a relationship to an organization. A provider renders services to patients at a location.
  • When the provider is an organization, there may also be a relationship to a practitioner. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization.

Two of the key profile changes to PractitionerRole relative to U.S. Core are:

  • Practitioner to 0..1 to allow a role definition without assigning it to a specific practitioner
  • Organization to 0..1 to allow an individual practitioner that does not have an organization with an NPI

The PractitionerRole structure is derived from the FHIR R4 PractitionerRole resource. However, this is not the latest version of the resource. If you wish to view the latest version, you can find the link in the shaded box near the top of the linked page.

The PractitionerRole resource provides the details of roles that the practitioner is approved to perform for which organizations, at which locations the provider is approved to provide healthcare services, and optionally what services the practitioner is approved to perform.

References

Many of the defined elements in a resource are references to other resources. Using these references, the resources combine to build a web of information about healthcare. The PractitionerRole profile references:

Note: Not all resources may be available for all provider directories.

Constraint

Constraint for path PractitionerRole:
ID Details
practitioner-or-organization-or-healthcareservice-or-location If PlannetPractitionerRole.practitioner is absent, PlannetPractitionerRole.organization, PlannetPractitionerRole.healthcareservice, and PlannetPractitionerRole.location must be present.

Expression:
practitioner.exists() or (organization.exists() or healthcareservice.exists() or location.exists())

Syntax

Currently, you use the following syntax to search for a practitioner role: https://[base_url]/PractitionerRole/PD-[NPI Number]-role

Anticipated Queries

Use Postman to test Opala’s Provider Directory API by querying the API and returning the results. Opala’s Collection is a group of API requests that are already saved in the Postman app and arranged in folders. Within each folder are pre-defined requests that you can run as-is or modify to fit your own needs.

Contact us to request a copy of the Postman collection for the Provider Directory API.

Search PractitionerRole

Retrieve all PractitionerRole resources.

GET {{baseurl}}/PractitionerRole

Search by Location

Retrieve the PractitionerRoles available at the specified location.

GET {{baseurl}}/PractitionerRole?location=Location/[location]

Search Practitioner

Retrieve roles filled by the specified practitioner.

GET {{baseurl}}/PractitionerRole?practitioner=Practitioner/[practitioner]

Search Services

Select PractitionerRoles providing the specified service.

GET {{baseurl}}/PractitionerRole?healthcareService=HealthcareService/[service]

Examples

More Information about the Plan-Net PractitionerRole profile