Optum

Optum Provider Participation List API

The Provider Participation List API from Optum — 1 operation(s) for provider participation list.

GitHub OpenAPI

Operations 1

GET /v1/vendors/providerparticipation NCC Provider participation list API #

Documentation

📖
APIReference
https://developer.optum.com/eligibilityandclaims/reference/api-overview
📖
GettingStarted
https://developer.optum.com/eligibilityandclaims/docs/get-started-with-optum-api
📖
Authentication
https://developer.optum.com/eligibilityandclaims/docs/optum-security-and-authorization
📖
APIReference
https://developer.optum.com/optumreal-dental/reference/overview-real-dental
📖
GettingStarted
https://developer.optum.com/optumreal-dental/reference/get-started
📖
APIReference
https://developer.optum.com/pharmacysolutions/reference
📖
APIReference
https://developer.optum.com/paymentandreimbursement/reference
📖
APIReference
https://developer.optum.com/platformandinteroperability/reference
📖
APIReference
https://developer.optum.com/analyticsandinsights/reference
📖
APIReference
https://developer.optum.com/apitools/reference/security-and-authorization-v2-overview
📖
Documentation
https://developer.optum.com/apitools/docs/getting-started

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/optum/refs/heads/main/openapi/optum-provider-participation-list-api-openapi.yml

Other Resources

🔗
ChangeLog
https://developer.optum.com/eligibilityandclaims/docs/eligibility-release-notes

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OpenAPI Specification

optum-provider-participation-list-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: NCC Data Acquisition Provider Participation List API
  version: 1.0.0
  description: 'The National Clinical Clearing(NCC) Data Acquisition API provides users with a REST-based solution for requesting and receiving clinical data from the chosen data vendor through the NCC platform. Authentication: All API''s requires JWT based authentication.'
servers:
- url: https://gateway-nonprod.optuminsightplatform.com/odxcloudapigatewaypreprod/ncc
  variables: {}
  description: Pre Prod
- url: https://gateway.optuminsightplatform.com/odxcloudapigateway/ncc
  variables: {}
  description: Prod
tags:
- name: Provider Participation List
paths:
  /v1/vendors/providerparticipation:
    get:
      summary: NCC Provider participation list API
      description: To fetch provider details in NCC, please use /findProviders legacy API. Either TIN or NPI is required.
      operationId: findProviders
      parameters:
      - name: tin
        in: query
        required: false
        schema:
          type: integer
          format: int64
      - name: npi
        in: query
        required: false
        schema:
          type: integer
          format: int64
      - name: startDate
        in: query
        required: false
        schema:
          type: string
          format: date
      - name: endDate
        in: query
        required: false
        schema:
          type: string
          format: date
      - name: requestType
        in: query
        required: false
        schema:
          type: string
          enum:
          - OR
          - AND
          - AND/OR
      - name: pageNo
        in: query
        required: false
        schema:
          type: integer
          format: int32
      - name: pageSize
        in: query
        required: false
        schema:
          type: integer
          format: int32
      - name: tenantId
        in: header
        required: true
        schema:
          type: integer
          format: int64
      - name: clientOrgId
        in: header
        required: true
        schema:
          type: integer
          format: int64
      - name: acceptEncoding
        in: header
        required: true
        schema:
          type: string
          example: gzip
      security:
      - ncc_auth:
        - scope-1
      responses:
        '200':
          description: Successful operation
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiResponseProviderParticipationResponse'
        '401':
          description: User is unauthorized to access vendor order status API
          content:
            application/json:
              schema:
                type: object
                properties:
                  status:
                    type: integer
                    format: int64
                  error:
                    type: string
              examples:
                authError:
                  value:
                    error: Token is expired
                    status: 401
        '500':
          description: Application failed to retrieve provider details , Internal server error occured
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiErrorResponse'
              examples:
                internalError:
                  value:
                    status: 500
                    statusMessage: Internal Server Error
                    error:
                      status: INTERNAL_SERVER_ERROR
                      detail:
                        message: '{"status":"FAILED","error":{"code":"INTERNAL_SERVER_ERROR"}}'
      tags:
      - Provider Participation List
components:
  schemas:
    ProviderParticipation:
      type: object
      properties:
        vendor_orgId:
          type: string
        vendorName:
          type: string
          description: Vendor name. Possible values are Athena, Veradigm, Moxe, EPP etc.
        emrInternalOrgs:
          type: array
          items:
            type: object
            properties:
              emr_id:
                type: string
              emr:
                type: string
              providerInfo:
                type: array
                items:
                  $ref: '#/components/schemas/ProviderInfo'
    ApiErrorResponse:
      type: object
      properties:
        status:
          type: integer
          format: int32
        statusMessage:
          type: string
        error:
          $ref: '#/components/schemas/Error'
    Error:
      type: object
      properties:
        status:
          type: string
        detail:
          $ref: '#/components/schemas/ErrorDetail'
    ErrorDetail:
      type: object
      properties:
        code:
          type: string
        message:
          type: string
    ProviderInfo:
      type: object
      properties:
        provider_infoId:
          type: string
        provider_tin:
          type: string
        provider_npi:
          type: string
        firstName:
          type: string
        lastName:
          type: string
        provider_orgName:
          type: string
        provider_orgState:
          type: string
        provider_orgZip:
          type: string
        facility_name:
          type: string
        facility_npi:
          type: string
        facility_tin:
          type: string
        facility_state:
          type: string
        facility_zip:
          type: string
        creationDateTime:
          type: string
          format: date-time
        updatedDateTime:
          type: string
          format: date-time
        activeStartDate:
          type: string
          format: date
        activeEndDate:
          type: string
          format: date
        lastOptOutDate:
          type: string
          format: date
        optInStartDate:
          type: string
          format: date
        optInEndDate:
          type: string
          format: date
    ApiResponseProviderParticipationResponse:
      type: object
      properties:
        data:
          type: object
          properties:
            totalNoOfRecords:
              type: integer
              format: int64
              description: Total number of records available
            pageSize:
              type: integer
              format: int32
              description: Maximum number of records per page
            pageNumber:
              type: integer
              format: int32
              description: Current page number
            providerParticipation:
              type: array
              items:
                $ref: '#/components/schemas/ProviderParticipation'
        status:
          type: string
          description: HTTP Response Status
          example: success
        message:
          type: string
          description: Returns 'VENDOR MATCHED' message if records are found, otherwise 'NO VENDOR MATCHED'
          enum:
          - VENDOR MATCHED
          - NO VENDOR MATCHED
        error:
          $ref: '#/components/schemas/ApiErrorResponse'
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      bearerFormat: JWT
    ncc_auth:
      type: oauth2
      flows:
        authorizationCode:
          authorizationUrl: https://idx.linkhealth.com/auth
          tokenUrl: https://idx.linkhealth.com/auth/token
          scopes:
            scope-1: required scope for API access
x-readme:
  explorer-enabled: true
  proxy-enabled: true