{"schema":"gale.providerFacts/1","npi":"1366755209","url":"https://www.gale.care/providers/ca/madera/karen-fleming-md-1366755209","factsUrl":"https://www.gale.care/npi/1366755209.json","markdownUrl":"https://www.gale.care/npi/1366755209.md","generatedAt":"2026-11-03T01:57:47.098Z","exportId":"elig-ca-20261023T221350Z","factsHash":"d1feeefd6b63382a","factsChangedAt":"2026-10-22T00:00:00.000Z","index":{"robots":"index","basis":"index-all"},"summary":"Karen Fleming, MD (NPI 1366755209) is listed in the NPPES registry with the specialty Pediatric Anesthesiology Physician in Madera, CA, phone (559) 353-3000, as of the registry file of Jun 8, 2026.","identity":{"name":{"id":"name","value":"Karen Fleming","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Karen Fleming under NPI 1366755209, as of the registry file of Jun 8, 2026."},"credential":{"id":"credential","value":"MD","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists the credential MD for Karen Fleming, MD (NPI 1366755209), as of the registry file of Jun 8, 2026."},"specialty":{"id":"specialty","value":"Pediatric Anesthesiology Physician","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Karen Fleming, MD (NPI 1366755209) under the specialty Pediatric Anesthesiology Physician, as of the registry file of Jun 8, 2026."},"registryStage":{"id":"registry-stage","value":"as-listed","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry does not list Karen Fleming, MD (NPI 1366755209) under a training program, as of the registry file of Jun 8, 2026."},"npiIssued":{"id":"npi-issued","value":2010,"status":"confirmed","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry shows NPI 1366755209 (Karen Fleming, MD) issued in 2010, as of the registry file of Jun 8, 2026."},"practiceType":{"id":"practice-type","value":"not-sole-proprietor","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Karen Fleming, MD (NPI 1366755209) as not a sole proprietor, as of the registry file of Jun 8, 2026."}},"location":{"city":{"id":"city","value":"Madera","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists a practice location in Madera for Karen Fleming, MD (NPI 1366755209), as of the registry file of Jun 8, 2026."},"state":{"id":"state","value":"CA","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists a practice location in CA for Karen Fleming, MD (NPI 1366755209), as of the registry file of Jun 8, 2026."}},"contact":{"phone":{"id":"phone","value":"(559) 353-3000","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists (559) 353-3000 as the practice phone for Karen Fleming, MD (NPI 1366755209), as of the registry file of Jun 8, 2026."}},"care":{"video":{"id":"video","value":"both","status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G5","sentence":"DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for video and in-person visits on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."}},"insurance":{"rows":[{"id":"ins-alameda-medi-cal","value":{"payer":"alameda","payerLabel":"Alameda Alliance for Health","line":"medi-cal","products":["AAH"],"accepts":true,"setting":"office"},"status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G3","sentence":"Listed: DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for Alameda Alliance for Health Medi-Cal plans on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."},{"id":"ins-ccah-medi-cal","value":{"payer":"ccah","payerLabel":"Central California Alliance for Health","line":"medi-cal","products":["OOA"],"accepts":true,"setting":"office"},"status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G3","sentence":"Listed: DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for Central California Alliance for Health Medi-Cal plans on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."},{"id":"ins-medi-cal-ffs-medi-cal","value":{"payer":"medi-cal-ffs","payerLabel":"Medi-Cal fee-for-service","line":"medi-cal","products":["Medi-Cal FFS"],"accepts":true,"setting":null},"status":"confirmed","source":"dhcs-ffs-enrolled-2026-10-19","asOf":"2026-10-19","checkedAt":"2026-10-22T14:41:40Z","staleAfter":"2027-02-16","confidence":"high","gate":"G3","sentence":"Listed: DHCS Medi-Cal fee-for-service enrolment file listed Karen Fleming, MD (NPI 1366755209) for Medi-Cal fee-for-service on Oct 19, 2026."},{"id":"ins-partnership-medi-cal","value":{"payer":"partnership","payerLabel":"Partnership HealthPlan of California","line":"medi-cal","products":["Partnership Health Plan of CA"],"accepts":true,"setting":"both"},"status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G3","sentence":"Listed: DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for Partnership HealthPlan of California Medi-Cal plans on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."},{"id":"ins-sfhp-medi-cal","value":{"payer":"sfhp","payerLabel":"San Francisco Health Plan","line":"medi-cal","products":["SAN FRANCISCO HEALTH PLAN - NETWORK"],"accepts":true,"setting":"office"},"status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G3","sentence":"Listed: DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for San Francisco Health Plan Medi-Cal plans on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."},{"id":"ins-aetna-commercial","value":{"payer":"aetna","payerLabel":"Aetna","line":"commercial","products":["AHF HMO","HMO","Open Access Aetna Health Network Only","Open Access Aetna Health Network Option","QPOS"],"accepts":null,"setting":null},"status":"inferred","source":"aetna-tic-2026-10","asOf":"2026-10-05","checkedAt":"2026-10-22T17:01:05Z","staleAfter":"2027-04-03","confidence":"low","gate":"G3i","sentence":"Likely: Aetna's price file suggests Aetna pays Karen Fleming, MD (NPI 1366755209) for commercial plans (file of Oct 5, 2026). That is a lead, not a directory listing."},{"id":"ins-ahf-medi-cal","value":null,"status":"not-listed","source":"ahf-fhir-directory","asOf":"2026-09-19","checkedAt":"2026-10-22T14:57:40Z","staleAfter":"2027-03-18","confidence":"low","gate":"G3","sentence":"Not listed by AIDS Healthcare Foundation (PHP) Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in AIDS Healthcare Foundation (PHP)'s directory, file of Sep 19, 2026. That is not a no.","checkedSources":[{"source":"ahf-fhir-directory","asOf":"2026-09-19"}]},{"id":"ins-ahf-medicare-advantage","value":null,"status":"not-listed","source":"ahf-fhir-directory","asOf":"2026-09-15","checkedAt":"2026-10-22T14:57:40Z","staleAfter":"2027-03-14","confidence":"low","gate":"G3","sentence":"Not listed by AIDS Healthcare Foundation (PHP) Medicare Advantage plans for Karen Fleming, MD (NPI 1366755209) in AIDS Healthcare Foundation (PHP)'s directory, file of Sep 15, 2026. That is not a no.","checkedSources":[{"source":"ahf-fhir-directory","asOf":"2026-09-15"}]},{"id":"ins-bsc-commercial","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California commercial plans for Karen Fleming, MD (NPI 1366755209) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-bsc-marketplace","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California individual and family plans for Karen Fleming, MD (NPI 1366755209) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-bsc-medi-cal","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California Promise Health Plan Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-bsc-medicare-advantage","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California Medicare Advantage plans for Karen Fleming, MD (NPI 1366755209) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-caloptima-medi-cal","value":null,"status":"not-listed","source":"caloptima-fhir-directory","asOf":"2026-10-11","checkedAt":"2026-10-22T21:38:03Z","staleAfter":"2027-04-09","confidence":"low","gate":"G3","sentence":"Not listed by CalOptima Health Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in CalOptima Health's directory, file of Oct 11, 2026. That is not a no.","checkedSources":[{"source":"caloptima-fhir-directory","asOf":"2026-10-11"}]},{"id":"ins-calviva-medi-cal","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-21","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-19","confidence":"low","gate":"G3","sentence":"Not listed by CalViva Health Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Health Net's directory, file of Oct 21, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-21"}]},{"id":"ins-goldcoast-medi-cal","value":null,"status":"not-listed","source":"goldcoast-fhir-directory","asOf":"2026-10-09","checkedAt":"2026-10-22T14:57:24Z","staleAfter":"2027-04-07","confidence":"low","gate":"G3","sentence":"Not listed by Gold Coast Health Plan Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Gold Coast Health Plan's directory, file of Oct 9, 2026. That is not a no.","checkedSources":[{"source":"goldcoast-fhir-directory","asOf":"2026-10-09"}]},{"id":"ins-healthnet-commercial","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Health Net commercial plans for Karen Fleming, MD (NPI 1366755209) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-healthnet-marketplace","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Ambetter from Health Net individual and family plans for Karen Fleming, MD (NPI 1366755209) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-healthnet-medi-cal","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Health Net Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-healthnet-medicare-advantage","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Wellcare by Health Net Medicare Advantage plans for Karen Fleming, MD (NPI 1366755209) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-hpsj-medi-cal","value":null,"status":"not-listed","source":"hpsj-fhir-directory","asOf":"2026-10-02","checkedAt":"2026-10-22T21:41:38Z","staleAfter":"2027-03-31","confidence":"low","gate":"G3","sentence":"Not listed by Health Plan of San Joaquin Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Health Plan of San Joaquin's directory, file of Oct 2, 2026. That is not a no.","checkedSources":[{"source":"hpsj-fhir-directory","asOf":"2026-10-02"}]},{"id":"ins-iehp-marketplace","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-07-27","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-01-23","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) individual and family plans for Karen Fleming, MD (NPI 1366755209) in Inland Empire Health Plan (IEHP)'s directory, file of Jul 27, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-07-27"}]},{"id":"ins-iehp-medi-cal","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-07-29","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-01-25","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Inland Empire Health Plan (IEHP)'s directory, file of Jul 29, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-07-29"}]},{"id":"ins-iehp-medicare-advantage","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-10-16","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-04-14","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) Medicare Advantage plans for Karen Fleming, MD (NPI 1366755209) in Inland Empire Health Plan (IEHP)'s directory, file of Oct 16, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-10-16"}]},{"id":"ins-kern-medi-cal","value":null,"status":"not-listed","source":"kern-fhir-directory","asOf":"2026-10-09","checkedAt":"2026-10-22T15:04:08Z","staleAfter":"2027-04-07","confidence":"low","gate":"G3","sentence":"Not listed by Kern Family Health Care Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in Kern Family Health Care's directory, file of Oct 9, 2026. That is not a no.","checkedSources":[{"source":"kern-fhir-directory","asOf":"2026-10-09"}]},{"id":"ins-lacare-medi-cal","value":null,"status":"not-listed","source":"lacare-fhir-directory","asOf":"2026-10-19","checkedAt":"2026-10-22T15:06:55Z","staleAfter":"2027-04-17","confidence":"low","gate":"G3","sentence":"Not listed by L.A. Care Health Plan Medi-Cal plans for Karen Fleming, MD (NPI 1366755209) in L.A. Care Health Plan's directory, file of Oct 19, 2026. That is not a no.","checkedSources":[{"source":"lacare-fhir-directory","asOf":"2026-10-19"}]},{"id":"ins-medicare-medicare","value":null,"status":"not-listed","source":"cms-medicare-clinicians","asOf":"2026-10-02","checkedAt":"2026-10-22T14:36:32Z","staleAfter":"2027-01-30","confidence":"low","gate":"G3","sentence":"Not listed by Original Medicare for Karen Fleming, MD (NPI 1366755209) in CMS Medicare clinicians file, file of Oct 2, 2026. That is not a no.","checkedSources":[{"source":"cms-medicare-clinicians","asOf":"2026-10-02"}]}],"coverage":{"state":"CA","covered":true,"checkedAt":"2026-10-23T22:13:50Z"}},"publicRecord":{},"claim":{"claimed":false,"identityConfirmedOn":null},"actions":{"call":"tel:+15593533000","book":null,"payDoor":null,"saveContact":"/npi/1366755209.vcf","intent":null},"hiddenFacts":[],"answers":[{"q":"new-patients","status":"unknown","answer":"Gale has no record of whether Karen Fleming, MD (NPI 1366755209) is taking new patients. Ask the office.","factIds":[]},{"q":"insurance","status":"confirmed","answer":"Listed for Karen Fleming, MD (NPI 1366755209): Alameda Alliance for Health, Medi-Cal (Apr 21, 2026); Central California Alliance for Health, Medi-Cal (Apr 21, 2026); Medi-Cal fee-for-service (Oct 19, 2026); Partnership HealthPlan of California, Medi-Cal (Apr 21, 2026); San Francisco Health Plan, Medi-Cal (Apr 21, 2026). Each listing names its source and date.","factIds":["ins-alameda-medi-cal","ins-ccah-medi-cal","ins-medi-cal-ffs-medi-cal","ins-partnership-medi-cal","ins-sfhp-medi-cal"]},{"q":"cost","status":"unknown","answer":"Gale has no record of what a first visit with Karen Fleming, MD (NPI 1366755209) costs. Paying yourself? You can ask for a written Good Faith Estimate before the visit.","factIds":[]},{"q":"video","status":"confirmed","answer":"DHCS Medi-Cal plan network listing listed Karen Fleming, MD (NPI 1366755209) for video and in-person visits on Apr 21, 2026. The state file is old; Gale found no newer one.","factIds":["video"]},{"q":"where","status":"self-reported","answer":"Karen Fleming, MD (NPI 1366755209) is listed in Madera, CA by the NPPES registry, as of the registry file of Jun 8, 2026.","factIds":["city","state"]},{"q":"who-they-see","status":"unknown","answer":"Gale has no record of who Karen Fleming, MD (NPI 1366755209) sees. Ask the office.","factIds":[]},{"q":"help-with","status":"unknown","answer":"Gale has no record of what Karen Fleming, MD (NPI 1366755209) helps with beyond the registry specialty. Ask the office.","factIds":[]},{"q":"languages","status":"unknown","answer":"Gale has no record of the languages Karen Fleming, MD (NPI 1366755209) speaks. Ask the office.","factIds":[]},{"q":"how-to-book","status":"self-reported","answer":"Call (559) 353-3000, the practice phone the NPPES registry lists for Karen Fleming, MD (NPI 1366755209) (Jun 8, 2026).","factIds":["phone"]},{"q":"next-opening","status":"unknown","answer":"Gale has no record of the next opening for Karen Fleming, MD (NPI 1366755209). Ask the office.","factIds":[]}],"sources":[{"id":"nppes-registry","name":"NPPES registry (CMS)","kind":"registry","asserting":true,"fileDate":"2026-06-08","url":"https://npiregistry.cms.hhs.gov/provider-view/1366755209","handCheck":null},{"id":"aetna-tic-2026-10","name":"Aetna's price file","kind":"price-file","asserting":false,"fileDate":"2026-10-05","url":null,"handCheck":{"wrong":3,"checked":12,"at":"2026-10-22"}},{"id":"ahf-fhir-directory","name":"AIDS Healthcare Foundation (PHP)'s directory","kind":"directory","asserting":true,"fileDate":"2026-09-19","url":null,"handCheck":null},{"id":"bsc-fhir-directory","name":"Blue Shield of California's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":23,"checked":60,"at":"2026-10-22"}},{"id":"caloptima-fhir-directory","name":"CalOptima Health's directory","kind":"directory","asserting":true,"fileDate":"2026-10-11","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}},{"id":"cms-medicare-clinicians","name":"CMS Medicare clinicians file","kind":"cms-file","asserting":true,"fileDate":"2026-10-02","url":null,"handCheck":{"wrong":0,"checked":23,"at":"2026-10-22"}},{"id":"dhcs-ffs-enrolled-2026-10-19","name":"DHCS Medi-Cal fee-for-service enrolment file","kind":"state-file","asserting":true,"fileDate":"2026-10-19","url":null,"handCheck":null},{"id":"dhcs-mcp-274-listing","name":"DHCS Medi-Cal plan network listing","kind":"state-file","asserting":true,"fileDate":"2026-04-21","url":null,"handCheck":null},{"id":"goldcoast-fhir-directory","name":"Gold Coast Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-09","url":null,"handCheck":null},{"id":"healthnet-fhir-directory","name":"Health Net's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":6,"checked":12,"at":"2026-10-22"}},{"id":"hpsj-fhir-directory","name":"Health Plan of San Joaquin's directory","kind":"directory","asserting":true,"fileDate":"2026-10-02","url":null,"handCheck":null},{"id":"iehp-fhir-directory","name":"Inland Empire Health Plan (IEHP)'s directory","kind":"directory","asserting":true,"fileDate":"2026-10-16","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}},{"id":"kern-fhir-directory","name":"Kern Family Health Care's directory","kind":"directory","asserting":true,"fileDate":"2026-10-09","url":null,"handCheck":null},{"id":"lacare-fhir-directory","name":"L.A. Care Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-19","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}}],"terms":"https://www.gale.care/agents#terms","about":{"status":"How each fact is known. confirmed = Listed: a named directory, CMS file or state file lists it. inferred = Likely: a price file suggests it; a likely match is a lead, not a listing. self-reported: the clinician said it, to the NPPES registry or on Gale. not-listed: a source that lists every clinician it covers was read and does not list this one; that is not a no. unknown: no record; ask the office.","sentence":"The fact in one sentence that names the clinician, the NPI, the source and the date. It starts with the status word. Quote it whole.","asOf":"The date the source gives this record (YYYY-MM-DD). It is not the date of the event the record describes: an opt-out states its own start and end dates in its sentence.","checkedAt":"When Gale last read the source.","staleAfter":"After this date the fact keeps its status word and date, and staleNote says the record is old; later still it is dropped. A fact from a full CMS or state file the publisher has not replaced stays, marked stale, for as long as that file is the newest one, and its staleNote says Gale found no newer file.","staleNote":"On a fact past its fresh window only: the record's age, as its own sentence (\"The state file is old; Gale found no newer one.\"). It never changes the status.","confidence":"How far Gale trusts the source, measured on the source (high, medium, low, none). Never a judgment of the clinician.","cautions":"hand-check: Gale checked a sample of this source by hand and found errors (sources[].handCheck has the numbers). conflict: another source disagrees (see conflict). stale: the record is past its fresh window. A caution never changes the status.","gate":"The publication switch that lets this kind of fact show. It says nothing about the clinician.","checkedSources":"For a not-listed fact: each source that was read, with its date.","insurance.rows[].value":"payer is a short id for the plan and payerLabel its name. line is the kind of plan: commercial, marketplace (individual and family), medicare, medicare-advantage, medi-cal, tricare, va, workers-comp. accepts is true on a listing and false only on a dated refusal (a directory's \"not accepting\" or an opt-out), never from absence; on a lead (status inferred) it is null, because a price file never says a clinician accepts a plan. optOut, on an Original Medicare opt-out, is the opt-out's own start and end dates (from, to) from CMS's opt-out list. setting is where the listing says care happens (office, virtual, both), or null when the source does not say.","insurance.coverage":"covered: whether Gale read the insurance files for this state; checkedAt: when it last did.","sources[].kind":"registry: the NPPES registry. cms-file, state-file: government files. directory: an insurer's directory. price-file: an insurer's published rates, which give leads only. gale: Gale's booking system. clinician: the clinician on Gale.","sources[].fileDate":"The date of the source file Gale read.","sources[].handCheck":"Gale's hand check of the source: checked is how many of its entries Gale checked by hand, wrong how many of those were wrong, at the date of the check. It describes the source, not this clinician.","sources[].asserting":"true when the source lists every clinician it covers, so its silence can support a not-listed fact. Only such sources ever do.","factsHash":"Changes only when a fact changes, never on a re-check.","index.basis":"Why the page is or is not indexed. index-all: indexed. Anything else: not indexed, and no reason about the clinician is given.","exportId":"The data export the facts come from.","hiddenFacts":"Facts withheld because someone disputed them. No reason is given."}}