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Provider Directory
About this Directory
The information compiled in this directory comes from a variety of sources. Some of this information may not be verified. The composition of our provider network is subject to change without notice. Physicians may not notify the health plan of changes in their information, potentially making this information out of date since it was last verified.

Item Description Source Frequency of Validation
Practitioner Name The name of the physician. Practitioner Every 3 Years. Upon notification from Practitioner when changing a name.
Gender The gender of the physician. Practitioner Every 3 Years. Upon notification from Practitioner when updating information.
Specialty The type of care or conditions a practitioner specializes in, such as family medicine, pediatrics, cardiology, or dermatology. Practitioner Every 3 years. Upon notification from Practitioner when adding or changing a specialty.
Medical Group Affiliations The organizations, companies or medical groups the practitioner is employed by or associated with. An organization or group may have more than one care site. Practitioner Every 3 years. Upon notification from Practitioner when adding or changing a medical group affiliation.
Hospital Affiliations The name and street address of the hospital. Practitioner Every 3 years. Upon notification from Practitioner when adding or changing a hospital affiliation.
Hospital Name and Location The name of the hospital. Provider Every 3 Years. Upon notification from Provider when updating information.
Hospital Accreditation An independent organization approved by CMS to determine whether acute care hospitals meet Medicare requirements. The approved CMS hospitals accreditors are: Center for Improvement in Healthcare Quality (CIHQ), DNV GL, American Osteopathic Association/Healthcare Facilities Accreditation Program (HFAP) and the Joint Commission. Provider Every 3 years.
Hospital Quality Data Quality data from recognized national or state sources. Provider Every 3 years.
Board Certification Board certification involves rigorous testing by a recognized board of the American Board of Medical Specialties and is not required by most states. To verify a provider's board certification and status, visit the American Board of Medical Specialties. Practitioner Every 3 years. Upon notification from Provider when renewing, adding or changing a board certification. Quarterly review of expired boards.
Accepting New Patients? Indicates whether a primary care practitioner or personal physician is accepting new patients. A practitioner may have a full patient roster and cannot accept any new patients at this time. Practitioner Every 3 years. Upon notification from Provider when adding or changing practice language information.
Languages Spoken Languages, in addition to English, spoken by the practitioner and/or staff. Practitioner Every 3 years. Upon notification from Provider when adding or changing practice language information.
Office Locations Site(s) where the practitioner cares for patients. Practitioner Every 3 years. Upon notification from Provider when adding or changing location information.