{"schema":"gale.providerFacts/1","npi":"1548962913","url":"https://www.gale.care/providers/ca/los-angeles/austin-borja-md-1548962913","factsUrl":"https://www.gale.care/npi/1548962913.json","markdownUrl":"https://www.gale.care/npi/1548962913.md","generatedAt":"2026-10-24T06:42:17.248Z","exportId":"elig-ca-20261023T221350Z","factsHash":"29d70298a6ef24e5","factsChangedAt":"2026-10-23T00:00:00.000Z","index":{"robots":"index","basis":"index-all"},"summary":"Austin Borja, MD (NPI 1548962913) is listed in the NPPES registry under a training program in Los Angeles, CA, phone (951) 743-0056, as of the registry file of Jun 8, 2026.","identity":{"name":{"id":"name","value":"Austin Borja","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Austin Borja under NPI 1548962913, 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 Austin Borja, MD (NPI 1548962913), as of the registry file of Jun 8, 2026."},"specialty":{"id":"specialty","value":"Student in an Organized Health Care Education/Training Program","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Austin Borja, MD (NPI 1548962913) under the specialty Student in an Organized Health Care Education/Training Program, as of the registry file of Jun 8, 2026."},"registryStage":{"id":"registry-stage","value":"student","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Austin Borja, MD (NPI 1548962913) under a training program, as of the registry file of Jun 8, 2026."},"npiIssued":{"id":"npi-issued","value":2023,"status":"confirmed","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry shows NPI 1548962913 (Austin Borja, MD) issued in 2023, as of the registry file of Jun 8, 2026."},"practiceType":{"id":"practice-type","value":"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 Austin Borja, MD (NPI 1548962913) as a sole proprietor, as of the registry file of Jun 8, 2026."}},"location":{"city":{"id":"city","value":"Los Angeles","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 Los Angeles for Austin Borja, MD (NPI 1548962913), 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 Austin Borja, MD (NPI 1548962913), as of the registry file of Jun 8, 2026."}},"contact":{"phone":{"id":"phone","value":"(951) 743-0056","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists (951) 743-0056 as the practice phone for Austin Borja, MD (NPI 1548962913), as of the registry file of Jun 8, 2026."}},"care":{"newPatients":{"id":"new-patients","value":true,"status":"confirmed","source":"cigna-fhir-directory","asOf":"2026-10-18","checkedAt":"2026-10-22T21:36:04Z","staleAfter":"2027-01-16","confidence":"high","gate":"G4","sentence":"Cigna's directory listed Austin Borja, MD (NPI 1548962913) as taking new patients on Oct 18, 2026."}},"insurance":{"rows":[{"id":"ins-cigna-commercial","value":{"payer":"cigna","payerLabel":"Cigna / Evernorth","line":"commercial","products":["CALIFORNIA OAP DIRECT","CALIFORNIA PPO-PPA DIRECT","SOUTHERN CA LOCALPLUS DIRECT"],"accepts":true,"setting":"office"},"status":"confirmed","source":"cigna-fhir-directory","asOf":"2026-10-18","checkedAt":"2026-10-22T21:36:04Z","staleAfter":"2027-04-16","confidence":"high","gate":"G3","sentence":"Listed: Cigna's directory listed Austin Borja, MD (NPI 1548962913) for Cigna / Evernorth commercial plans on Oct 18, 2026. Gale checked 51 listings in this directory by hand on Oct 22, 2026; 3 were wrong, so confirm with the office.","cautions":["hand-check"]},{"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 Austin Borja, MD (NPI 1548962913) for Medi-Cal fee-for-service on Oct 19, 2026."},{"id":"ins-aetna-commercial","value":{"payer":"aetna","payerLabel":"Aetna","line":"commercial","products":["AHF Choice POS II","AHF OA MC","AHF Open Access Aetna Select","Aetna Choice POS II","Aetna Open Access Health Network Only","Aetna Select","HF OPEN POS II","HMO"],"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 Austin Borja, MD (NPI 1548962913) for commercial plans (file of Oct 5, 2026). That is a lead, not a directory listing."},{"id":"ins-medicare-medicare","value":{"payer":"medicare","payerLabel":"Original Medicare","line":"medicare","products":["Medicare Part B"],"accepts":null,"setting":"office"},"status":"inferred","source":"cms-medicare-clinicians","asOf":"2026-10-02","checkedAt":"2026-10-22T14:36:32Z","staleAfter":"2027-01-30","confidence":"low","gate":"G3i","sentence":"Likely: CMS Medicare clinicians file suggests Original Medicare pays Austin Borja, MD (NPI 1548962913) for Medicare (file of Oct 2, 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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-ccah-medi-cal","value":null,"status":"not-listed","source":"ccah-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T14:57:43Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Central California Alliance for Health Medi-Cal plans for Austin Borja, MD (NPI 1548962913) in Central California Alliance for Health's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"ccah-fhir-directory","asOf":"2026-10-22"}]},{"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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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-humana-medicare-advantage","value":null,"status":"not-listed","source":"humana-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T21:53:28Z","staleAfter":"2027-04-21","confidence":"low","gate":"G3","sentence":"Not listed by Humana Medicare Advantage plans for Austin Borja, MD (NPI 1548962913) in Humana's directory, file of Oct 23, 2026. That is not a no.","checkedSources":[{"source":"humana-fhir-directory","asOf":"2026-10-23"}]},{"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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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 Austin Borja, MD (NPI 1548962913) 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-partnership-medi-cal","value":null,"status":"not-listed","source":"partnership-fhir-directory","asOf":"2026-10-16","checkedAt":"2026-10-22T21:38:25Z","staleAfter":"2027-04-14","confidence":"low","gate":"G3","sentence":"Not listed by Partnership HealthPlan of California Medi-Cal plans for Austin Borja, MD (NPI 1548962913) in Partnership HealthPlan of California's directory, file of Oct 16, 2026. That is not a no.","checkedSources":[{"source":"partnership-fhir-directory","asOf":"2026-10-16"}]},{"id":"ins-sfhp-medi-cal","value":null,"status":"not-listed","source":"sfhp-fhir-directory","asOf":"2026-10-01","checkedAt":"2026-10-22T14:56:20Z","staleAfter":"2027-03-30","confidence":"low","gate":"G3","sentence":"Not listed by San Francisco Health Plan Medi-Cal plans for Austin Borja, MD (NPI 1548962913) in San Francisco Health Plan's directory, file of Oct 1, 2026. That is not a no.","checkedSources":[{"source":"sfhp-fhir-directory","asOf":"2026-10-01"}]}],"coverage":{"state":"CA","covered":true,"checkedAt":"2026-10-23T22:13:50Z"}},"publicRecord":{},"claim":{"claimed":false,"identityConfirmedOn":null},"actions":{"call":"tel:+19517430056","book":null,"payDoor":null,"saveContact":"/npi/1548962913.vcf","intent":null},"hiddenFacts":[],"answers":[{"q":"new-patients","status":"confirmed","answer":"Cigna's directory listed Austin Borja, MD (NPI 1548962913) as taking new patients on Oct 18, 2026.","factIds":["new-patients"]},{"q":"insurance","status":"confirmed","answer":"Listed for Austin Borja, MD (NPI 1548962913): Cigna / Evernorth, commercial (Oct 18, 2026); Medi-Cal fee-for-service (Oct 19, 2026). Each listing names its source and date.","factIds":["ins-cigna-commercial","ins-medi-cal-ffs-medi-cal"]},{"q":"cost","status":"unknown","answer":"Gale has no record of what a first visit with Austin Borja, MD (NPI 1548962913) costs. Paying yourself? You can ask for a written Good Faith Estimate before the visit.","factIds":[]},{"q":"video","status":"unknown","answer":"Gale has no record of whether Austin Borja, MD (NPI 1548962913) offers video visits. Ask the office.","factIds":[]},{"q":"where","status":"self-reported","answer":"Austin Borja, MD (NPI 1548962913) is listed in Los Angeles, 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 Austin Borja, MD (NPI 1548962913) sees. Ask the office.","factIds":[]},{"q":"help-with","status":"unknown","answer":"Gale has no record of what Austin Borja, MD (NPI 1548962913) helps with beyond the registry specialty. Ask the office.","factIds":[]},{"q":"languages","status":"unknown","answer":"Gale has no record of the languages Austin Borja, MD (NPI 1548962913) speaks. Ask the office.","factIds":[]},{"q":"how-to-book","status":"self-reported","answer":"Call (951) 743-0056, the practice phone the NPPES registry lists for Austin Borja, MD (NPI 1548962913) (Jun 8, 2026).","factIds":["phone"]},{"q":"next-opening","status":"unknown","answer":"Gale has no record of the next opening for Austin Borja, MD (NPI 1548962913). 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/1548962913","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":"ccah-fhir-directory","name":"Central California Alliance for Health's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":null},{"id":"cigna-fhir-directory","name":"Cigna's directory","kind":"directory","asserting":false,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":3,"checked":51,"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":"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":"humana-fhir-directory","name":"Humana's directory","kind":"directory","asserting":true,"fileDate":"2026-10-23","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"}},{"id":"partnership-fhir-directory","name":"Partnership HealthPlan of California's directory","kind":"directory","asserting":true,"fileDate":"2026-10-16","url":null,"handCheck":null},{"id":"sfhp-fhir-directory","name":"San Francisco Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-01","url":null,"handCheck":null}],"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, up to 270 days after the file's date, 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."}}