Priority Partners offers a Provider Directory service using API technology, which helps applications share data and work better together. This Provider Directory API enables third-party applications to retrieve up-to-date information about Johns Hopkins Health Plans’ (JHHP) in-network providers, facilities, pharmacies and insurance plans. This API is built using FHIR standards and is designed to meet CMS-9115 requirements for payer data interoperability and public access.

These APIs follow the HL7 R4 FHIR specification, as well as the DaVinci PDEX Plan Net Implementation Guide.

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What’s the Purpose?

As part of the CMS-9115 rule, payers like JHHP are required to expose provider network information through a standards-based FHIR API. The Provider Directory API enables developers to build applications that allow users to search for and filter health care providers by location, specialty, plan network and more, all using machine-readable data that stays up to date.

Why it Matters for Developers

This API allows developers to create directories, search tools, care navigation apps and other use cases that require timely, reliable access to provider network information. The use of FHIR ensures interoperability with other health care APIs.

Johns Hopkins Health Plans LLC Capability Statement

Davinci FHIR (HL7® FHIR® Standard) R4

Healthcare Service API Digital Endpoint

The Healthcare Service resource defines the specific health care services offered by a provider or organization at a particular location.

https://api.jhhpfhir.com/r4/public-pp/HealthcareService

Questions? Send us an email.

Insurance Plan API Digital Endpoint

The Insurance Plan resource returns metadata about Priority Partners’ plans, including coverage areas, network affiliations and identifiers.

https://api.jhhpfhir.com/r4/public-pp/InsurancePlan

Questions? Send us an email.

Practitioner API Digital Endpoint

The Practitioner resource provides demographic and professional details about individual health care professionals, such as names, specialties and credentials.

https://api.jhhpfhir.com/r4/public-pp/Practitioner

Questions? Send us an email.

Organization API Digital Endpoint

The Organization resource provides information about health care organizations (e.g., hospitals, group practices, pharmacies), including names, contact info and identifiers.

https://api.jhhpfhir.com/r4/public-pp/Organization

Questions? Send us an email.

Location API Digital Endpoint

The Location resource describes physical sites where care is delivered, including address, hours of operation and contact details.

https://api.jhhpfhir.com/r4/public-pp/Location

Questions? Send us an email.

Organization Affiliation API Digital Endpoint

The Organization Affiliation resource presents relationships between organizations, i.e., which organizations operate under a parent health system, share services or collaborate.

https://api.jhhpfhir.com/r4/public-pp/OrganizationAffiliation

Questions? Send us an email.

Practitioner Role API Digital Endpoint

The Practitioner Role resource represents the relationship between a provider or pharmacy and an insurance plan. It links to the Practitioner, Organization and Location resources, gives a complete view of who delivers care, under what plan, and where.

https://api.jhhpfhir.com/r4/public-pp/PractitionerRole

Questions? Send us an email.

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