The Individual Provider Network Data displays information on individuals participating in health plan networks from April through June, 2019. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans. For more information, please visit: https://pndslookup.health.ny.gov.
This dataset has the following 87 columns:
| Column Name | API Column Name | Data Type | Description | Sample Values |
|---|---|---|---|---|
| Last Name | stdlastname | text | Standardized last name of provider | LEE KIM PATEL SHAH COHEN view top 100 |
| First Name | stdfirstname | text | Standardized first name of provider | MICHAEL DAVID ROBERT JOHN JOSEPH view top 100 |
| National Provider Identifier | npi | text | The National Provider Identifier (NPI) is a 10-digit identification number issued to health care providers | 9999999999 8888888888 1063490266 1902896541 1376586065 view top 100 |
| Medicaid Provider Identification Number | medsid | text | 99999999 88888888 01666119 00244528 00695941 view top 100 | |
| Site Name | sitename | text | Standardized name of the office or facility building | NA NORTH SHORE LIJ MEDICAL NYU RADIOLOGY ASSOCIATES PROHEALTH CARE ASSOCIATES NORTH SHORE LIJ MEDICAL PC view top 100 |
| Room or Suite | rmnumber | text | Room or suite number of the provider’s office | NA na N/A Suite 1 fl 2 view top 100 |
| Street Address | address1_std | text | Standardized street address of the site | 300 COMMUNITY DR 111 E 210TH ST 601 ELMWOOD AVE 27005 76TH AVE 1 GUSTAVE L LEVY PL view top 100 |
| Town/City | city_std | text | Standardized name of the town or city | NEW YORK BROOKLYN BRONX BUFFALO ROCHESTER view top 100 |
| County | truecountyname | text | County Name | New York Nassau Kings Suffolk Queens view top 100 |
| Borough/County Code | truecountyfips | text | Federal Information Processing Standard (FIPS) county or borough code, based on geolocation | 36061 36059 36047 36103 36081 view top 100 |
| State | state_std | text | Standardized state name | NY NJ PA CT VT view top 100 |
| Zip Code | zip_std | text | Standardized zip code | 10016 10461 10029 10467 10032 view top 100 |
| Latitude | latitude | number | System-generated latitude for reported address | 40.775606 40.880141 77.623866 40.753447 40.790521 view top 100 |
| Longitude | longitude | number | System-generated longitude for reported address | -73.70132 -73.87987 -43.124247 -73.706884 -73.953634 view top 100 |
| Wheel Chair Accessibility | wheelchr | number | Whether the office is wheelchair accessible 0=No 1=Yes | 1 0 view top 100 |
| Primary designation | primdesg | number | Primary designation of a provider. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 2 1 3 view top 100 |
| Provider Type | provtype | text | Degree or licensure of the provider. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 01 08 02 23 06 view top 100 |
| Primary Specialty | primspec | text | Primary specialty of the provider. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 200 060 800 020 201 view top 100 |
| Secondary Specialty | secdspec | text | Secondary specialty of the provider. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 999 060 201 200 779 view top 100 |
| Board Status - Primary Specialty | brdstat | text | Level of education/training completed by a provider towards a recognized medical specialty certificate for the provider’s primary specialty. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 3 9 2 4 1 view top 100 |
| Board Status - Secondary Specialty | brdstat2 | text | Level of education/training completed by a provider towards a recognized medical specialty certificate for the provider’s secondary specialty. Refer to codes in the PNDS data dictionary: https://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf | 9 3 4 2 1 view top 100 |
| Provider’s Gender | gender | text | 1=Male 2=Female | 1 2 view top 100 |
| Commercial Provider Indicator | commind | number | 0=No 1=Yes | 0 1 view top 100 |
| Medicaid Provider Indicator | mcaidind | number | 0=No 1=Yes | 0 1 view top 100 |
| CHP Indicator | chpind | number | Child Health Plus (CHP) Indicator 0=No 1=Yes | 0 1 view top 100 |
| HARP Indicator | harpind | number | Health and Recovery Plan Indicator (HARP) 0=No 1=Yes | 0 1 view top 100 |
| Medicaid Advantage Indicator | maind | number | 0=No 1=Yes | 0 1 view top 100 |
| Partial CAPS Indicator | pcapind | number | Partial Capitated (CAPS) Indicator 0=No 1=Yes | 0 1 view top 100 |
| MAP Indicator | mapind | number | Medicaid Advantage Plus (MAP) Indicator 0=No 1=Yes | 0 1 view top 100 |
| PACE Indicator | paceind | number | Programs of All-Inclusive Care for the Elderly (PACE) Indicator 0=No 1=Yes | 0 1 view top 100 |
| FIDA Indicator | fidaind | number | Fully-Integrated Dual Advantage (FIDA) Indicator 0=No 1=Yes | 0 1 view top 100 |
| FIDA IDD Indicator | fidaiddind | number | Fully-Integrated Dual Advantage for Individuals with Intellectual and Developmental Disabilities (FIDAIDD) Indicator 0=No 1=Yes | 0 1 view top 100 |
| HIV SNP Indicator | hivsnpind | number | HIV (Human Immunodeficiency Virus) Special Needs Plans Indicator 0=No 1=Yes | 0 1 view top 100 |
| SIP-PL Indicator | sipind | number | SIP-PL (Specialized I/DD Plans- Provider Led) Indicator 0=No 1=Yes | 0 view top 100 |
| NYSOH Standard Essential Health Plan (EP) Indicator/Basic Health Program Indicator | bhpind | number | New York State of Health Standard Essential Health Plan (EP) Indicator/Basic Health Program Indicator 0=No 1=Yes | 0 1 view top 100 |
| NYSOH EP Plus Adult Vision/Dental Indicator/Basic Health Program Adult Indicator | bhpaind | number | New York State of Health (NYSOH) Standard Essential Health Plan (EP) Indicator/Basic Health Program Indicator 0=No 1=Yes | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 1 | nonmcomed1ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 1 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 1 0 view top 100 |
| Commercial Non-MCO Medical Indicator 2 | nonmcomed2ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 2 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 3 | nonmcomed3ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 3 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 4 | nonmcomed4ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 4 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 5 | nonmcomed5ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 5 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 2 | nonmcomed6ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 6 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Medical Indicator 7 | nonmcomed7ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 7 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 view top 100 |
| Commercial Non-MCO Medical Indicator 8 | nonmcomed8ind | number | Commercial Non-Managed Care Organization (MCO) Medical Indicator 8 0=No 1=Yes Commercial Non-MCO Medical Indicator (1-8) THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 view top 100 |
| Commercial Non-MCO Vision Indicator 1 | nonmcovis1ind | number | Commercial Non-Managed Care Organization (MCO) Vision 1 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Vision Indicator 2 | nonmcovis2ind | number | Commercial Non-Managed Care Organization (MCO) Vision 2 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Vision Indicator 3 | nonmcovis3ind | number | Commercial Non-Managed Care Organization (MCO) Vision 3 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Vision Indicator 4 | nonmcovis4ind | number | Commercial Non-Managed Care Organization (MCO) Vision 4 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Vision Indicator 5 | nonmcovis5ind | number | Commercial Non-Managed Care Organization (MCO) Vision 5 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Vision Indicator 6 | nonmcovis6ind | number | Commercial Non-Managed Care Organization (MCO) Vision 6 Indicator 0=No 1=Yes Commercial Non-MCO Vision Indicator 1-6 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Dental Indicator 1 | nonmcodent1ind | number | Commercial Non-Managed Care Organization (MCO) Dental 1 Indicator 0=No 1=Yes Commercial Non-MCO Dental Indicator 1-5 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Dental Indicator 2 | nonmcodent2ind | number | Commercial Non-Managed Care Organization (MCO) Dental 2 Indicator 0=No 1=Yes Commercial Non-MCO Dental Indicator 1-5 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Dental Indicator 3 | nonmcodent3ind | number | Commercial Non-Managed Care Organization (MCO) Dental 3 Indicator 0=No 1=Yes Commercial Non-MCO Dental Indicator 1-5 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Dental Indicator 4 | nonmcodent4ind | number | Commercial Non-Managed Care Organization (MCO) Dental 4 Indicator 0=No 1=Yes Commercial Non-MCO Dental Indicator 1-5 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Commercial Non-MCO Dental Indicator 5 | nonmcodent5ind | number | Commercial Non-Managed Care Organization (MCO) Dental 5 Indicator 0=No 1=Yes Commercial Non-MCO Dental Indicator 1-5 THIS IS CONSOLIDATED IN THE DICTIONARY ONLY | 0 1 view top 100 |
| Hospital Affiliation Operating Certificate (OPCERT) #1 | hospcert | text | Operating certificate (OPCERT) number of hospitals affiliated with the provider (1-3) | 99999999 7002053H 7002054H 7002024H 7000006H view top 100 |
| HA PFI #1 | pficert1 | text | Permanent Facility Identifier (PFI) corresponding to HAOPECRT (1-3) | 999999 001463 001456 001630 000541 view top 100 |
| Hospital Affiliation Operating Certificate (OPCERT) #2 | hspcert2 | text | Operating certificate (OPCERT) number of hospitals affiliated with the provider (1-3) | 99999999 7003004H 7000006H 7002053H 2951001H view top 100 |
| HA PFI #2 | pficert2 | text | Permanent Facility Identifier (PFI) corresponding to HAOPECRT (1-3) | 999999 001630 000541 001463 001169 view top 100 |
| Hospital Affiliation Operating Certificate (OPCERT) #3 | hspcert3 | text | Operating certificate (OPCERT) number of hospitals affiliated with the provider (1-3) | 99999999 7000006H 7003004H 2951001H 7002053H view top 100 |
| HA PFI #3 | pficert3 | text | Permanent Facility Identifier (PFI) corresponding to HAOPECRT (1-3) | 999999 000541 001168 001463 001630 view top 100 |
| Provider Location Facility Operating Number | provcert | text | Operating certificate (OPCERT) number of the provider’s location | 99999999 00000000 7002053H 7000006H 7002001H view top 100 |
| PFI | provpfi | text | The Permanent Facility Identifier (PFI) of the provider’s location | 999999 000000 001438 001301 001626 view top 100 |
| Language 1 | lang1 | text | Language that a provider or clinical staff member can speak to a member (1-7) | ENG 999 SPA CHI RUS view top 100 |
| Language 2 | lang2 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 SPA RUS FRE HIN view top 100 |
| Language 3 | lang3 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 SPA RUS FRE HIN view top 100 |
| Language 4 | lang4 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 SPA RUS ENG AMH view top 100 |
| Language 5 | lang5 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 SPA ENG AUS RUS view top 100 |
| Language 6 | lang6 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 SPA ENG BAK RUS view top 100 |
| Language 7 | lang7 | text | Language that a provider or clinical staff member can speak to a member (1-7) | 999 ENG BAN SPA RUS view top 100 |
| NYSOH Individual Network 1 Indicator | nysohmedical1ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Network 2 Indicator | nysohmedical2ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Network 3 Indicator | nysohmedical3ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Network 4 Indicator | nysohmedical4ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Network 5 Indicator | nysohmedical5ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 view top 100 |
| NYSOH Individual Network 6 Indicator | nysohmedical6ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 view top 100 |
| NYSOH Individual Network 7 Indicator | nysohmedical7ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 view top 100 |
| NYSOH Individual Network 8 Indicator | nysohmedical8ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 view top 100 |
| NYSOH Individual Network 9 Indicator | nysohmedical9ind | number | New York State of Health (NYSOH) Individual Network Indicator (1-10) 0=No 1=Yes | 0 view top 100 |
| NYSOH Individual Dental Network 1 Indicator | nysohdental1ind | number | New York State of Health (NYSOH) Individual Dental Network Indicator (1-4) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Dental Network 2 Indicator | nysohdental2ind | number | New York State of Health (NYSOH) Individual Dental Network Indicator (1-4) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Dental Network 3 Indicator | nysohdental3ind | number | New York State of Health (NYSOH) Individual Dental Network Indicator (1-4) 0=No 1=Yes | 0 1 view top 100 |
| NYSOH Individual Dental Network 4 Indicator | nysohdental4ind | number | New York State of Health (NYSOH) Individual Dental Network Indicator (1-4) 0=No 1=Yes | 0 1 view top 100 |
| Site NPI | sitenpi | text | Provider facility’s National Provider Identifier (NPI | 9999999999 1053688572 1063525152 1730491945 1235483504 view top 100 |
| Plan Name | planname | text | Name of submitted health plan | UnitedHealthcare Insurance Company of New York: Empire Plan Health Insurance Plan of Greater New York, Inc. UnitedHealthcare of New York, Inc.: QHP Jefferson-Lewis Et. Al. School Employees’ Healthcare Plan DBA Jefferson Lewis Choice Plus Network Cigna Health and Life Insurance Company, Inc: Medical PPO Network view top 100 |
| PNDSID | pndsid | text | Provider Network Data System (PNDS) identification number associated with plan submitter | 0125 0050 0149 0212 0137 view top 100 |
| Quarter/Year | quarter | text | Quarter and year of data submission | Quarter2 2019 view top 100 |