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·bronze
Rows
N/A
Columns
18
History
N/A
Card
nocolumns only
Typed tools
3

What it is

  1. 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).
  2. 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".
  3. 3Typed tools (get_plan_network, is_provider_in_plan, get_network_change) are proposed and start on Ben's go.

Grain

KeyGrain
N/A
  1. 1One row per listing observation: plan_year x cms_plan_id (H1234-001-000) x npi x the location as listed (location_name, city, state, zip5, phone) x the source page (url, page, raw_sha256).
  2. 2No unique row key: the membership grain is (plan_year, cms_plan_id, npi), served DISTINCT, never as raw row counts.
  3. 3Stage 20 (dataset_id 7bceef45cc9e5910e64caa428a1f3e40869f91d149c4e19f08cc55f5e468ba7c, 2026-11-02): 2026 218,950,666 rows / 645 contracts / 3,581 plans / 2,437,003 NPIs;
  4. 42027 289,906,332 / 614 / 4,305 / 2,421,994; plan_year unknown 826,292 rows (4 contracts), excluded from answers.

Columns (18)

ColumnTypeMeaning
plan_yearstring
cms_plan_idstring
contract_idstring
plan_key_basisstring
npistring
npi_basisstring
gradestring
provider_name_printedstring
specialtystring
location_namestring
citystring
statestring
zip5string
phonestring
pagestring
source_groupstring
urlstring
raw_sha256string

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")
ItemValue
Typed tools that read itget_network_change, get_plan_network, is_provider_in_plan
Identity keynpi
Joinhow_to_join(source_fqn="medicare_bronze.ma_directory_plan_npi_site_v1")
Raw doorAthena (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