Medicare Advantage, Part D, Medicaid
MA plan networks: plan year x CMS plan x NPI x listed location (2026, 2027)
medicare_bronze.ma_directory_plan_npi_site_v1·partial·bronzeRows
N/A
Columns
18
History
N/A
Card
nocolumns only
Typed tools
3
What it is
- 1The Data Tracker's plan-network build (docs/data-tracker/SERVING-HANDOFF-PLAN-NETWORKS.md): which NPIs each Medicare Advantage plan lists, from the payer's own Plan-Net API, the printed directory, a name match to NPPES, or the Medicare Plan Finder export (npi_basis), with a grade on matched rows (A name+ZIP unique, B name+state unique, N name unique nationally: name-matched, never presented as printed) and plan_key_basis saying how the row reached its CMS plan id (the publisher's own id, a network map, or the CMS crosswalk carry-back: 2027 rows carrying plan_key_basis cy2026_directory_2027_not_yet_posted: 42 contracts / 1,132,045 members at stage 21 whose 2026 directory stands in; label or exclude them).
- 2A contract with no rows is UNCOVERED (the handoff's open-gap list), never "no network"; absence of an NPI is a claim only for a covered contract and only "not listed in the published directory".
- 3Typed tools (get_plan_network, is_provider_in_plan, get_network_change) are proposed and start on Ben's go.
Grain
| Key | Grain |
|---|---|
| N/A |
|
Columns (18)
| Column | Type | Meaning |
|---|---|---|
plan_year | string | |
cms_plan_id | string | |
contract_id | string | |
plan_key_basis | string | |
npi | string | |
npi_basis | string | |
grade | string | |
provider_name_printed | string | |
specialty | string | |
location_name | string | |
city | string | |
state | string | |
zip5 | string | |
phone | string | |
page | string | |
source_group | string | |
url | string | |
raw_sha256 | string |
Query it
describe_data_source(source_fqn="medicare_bronze.ma_directory_plan_npi_site_v1") # the card, live query_substrate(sql="SELECT * FROM medicare_bronze.ma_directory_plan_npi_site_v1 WHERE <filter> LIMIT 100")
| Item | Value |
|---|---|
| Typed tools that read it | get_network_change, get_plan_network, is_provider_in_plan |
| Identity key | npi |
| Join | how_to_join(source_fqn="medicare_bronze.ma_directory_plan_npi_site_v1") |
| Raw door | Athena (read-only via query_substrate): medicare_bronze.ma_directory_plan_npi_site_v1 WHERE dataset_id = '<the current publish>' (versioned: pin dataset_id; never count across datasets) |
This page as markdown: /docs-md/data/medicare_bronze_ma_directory_plan_npi_site_v1.md · every page in one file: /llms-full.txt