UnitedHealthcare

UnitedHealthcare Providers API

Provider demographics and directory

Documentation GitHub OpenAPI

Operations 1

GET /providers/v1/demographics UnitedHealthcare Provider Demographics #

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OpenAPI Specification

openapi: 3.2.0
info:
  title: UnitedHealthcare Provider Providers API
  description: The UnitedHealthcare Provider API provides real-time access to eligibility verification, claims management, prior authorization, and provider directory services for healthcare providers, payers, and health IT developers. Available through the UnitedHealthcare API Marketplace at apimarketplace.uhcprovider.com.
  version: '1.0'
  contact:
    name: UnitedHealthcare API Marketplace
    url: https://apimarketplace.uhcprovider.com
  license:
    name: UnitedHealthcare API Terms of Use
    url: https://apimarketplace.uhcprovider.com/legal
servers:
- url: https://api.uhcprovider.com
  description: Production
security:
- bearerAuth: []
tags:
- name: Providers
  description: Provider demographics and directory
paths:
  /providers/v1/demographics:
    get:
      operationId: getProviderDemographics
      summary: UnitedHealthcare Provider Demographics
      description: Retrieve demographic and credentialing information for healthcare providers in the UnitedHealthcare network, including contact details, specialties, network participation, and accepting new patients status.
      tags:
      - Providers
      x-microcks-operation:
        dispatcher: SCRIPT
        dispatcherRules: return 'FOUND';
      parameters:
      - name: npi
        in: query
        required: true
        description: National Provider Identifier (NPI) for the provider
        schema:
          type: string
          pattern: ^\d{10}$
      - name: state
        in: query
        required: false
        description: Two-letter state code to filter results
        schema:
          type: string
          maxLength: 2
      responses:
        '200':
          description: Provider demographic information
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ProviderDemographics'
        '400':
          description: Bad request
        '401':
          description: Unauthorized
        '404':
          description: Provider not found
        '429':
          description: Too many requests
components:
  schemas:
    ProviderDemographics:
      type: object
      description: Healthcare provider demographic and credentialing information
      properties:
        npi:
          type: string
          description: National Provider Identifier
        firstName:
          type: string
          description: Provider first name
        lastName:
          type: string
          description: Provider last name
        organizationName:
          type: string
          description: Organization name (for group practices)
        providerType:
          type: string
          enum:
          - INDIVIDUAL
          - ORGANIZATION
          description: Provider type
        specialty:
          type: string
          description: Primary specialty
        subspecialties:
          type: array
          description: List of subspecialties
          items:
            type: string
        networkStatus:
          type: string
          enum:
          - IN_NETWORK
          - OUT_OF_NETWORK
          description: Network participation status
        acceptingNewPatients:
          type: boolean
          description: Whether accepting new patients
        address:
          type: object
          description: Practice address
          properties:
            street1:
              type: string
            street2:
              type: string
            city:
              type: string
            state:
              type: string
            zip:
              type: string
        phone:
          type: string
          description: Office phone number
        languages:
          type: array
          description: Languages spoken
          items:
            type: string
        boardCertifications:
          type: array
          description: Board certifications
          items:
            type: string
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      description: OAuth 2.0 Bearer token from UnitedHealthcare API Marketplace
externalDocs:
  description: UnitedHealthcare API Marketplace Documentation
  url: https://apimarketplace.uhcprovider.com/#/