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BFD-4661: Use derived NPI type for claim care team providers #3257

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BFD-4661: Use derived NPI type for claim care team providers #3257

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98adca5
Use derived NPI type for claim care team providers
patrickgmayday Aug 12, 2026
10db248
Resolve merge conflicts from master and revert fromNpiTypeCode functi…
patrickgmayday Aug 13, 2026
c5659cd
SonarQube error for npiType var name resolution.
patrickgmayday Aug 13, 2026
86af842
Add missing provider NPI mappings for billing as that is part of care…
patrickgmayday Aug 13, 2026
c319c05
merge from master and change flyway script name to avoid conflict
patrickgmayday Aug 13, 2026
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37 changes: 37 additions & 0 deletions apps/bfd-db-migrator-ng/migrations/V1_39_0__add_claim_care_team_provider_npi_type.sql
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Original file line number Diff line number Diff line change
@@ -0,0 +1,37 @@
ALTER TABLE idr.claim_professional_ss
ADD COLUMN bfd_prvdr_othr_npi_type integer,
ADD COLUMN bfd_prvdr_rfrg_npi_type integer;

ALTER TABLE idr.claim_professional_nch
ADD COLUMN bfd_prvdr_rfrg_npi_type integer,
ADD COLUMN bfd_prvdr_srvc_npi_type integer;

ALTER TABLE idr.claim_item_institutional_nch
ADD COLUMN bfd_prvdr_rndrng_npi_type integer;

ALTER TABLE idr.claim_institutional_nch
ADD COLUMN bfd_prvdr_atndg_npi_type integer,
ADD COLUMN bfd_prvdr_oprtg_npi_type integer,
ADD COLUMN bfd_prvdr_othr_npi_type integer,
ADD COLUMN bfd_prvdr_rndrg_npi_type integer,
ADD COLUMN bfd_prvdr_rfrg_npi_type integer,
ADD COLUMN bfd_prvdr_srvc_npi_type integer;

ALTER TABLE idr.claim_item_institutional_ss
ADD COLUMN bfd_prvdr_rndrng_npi_type integer;

ALTER TABLE idr.claim_institutional_ss
ADD COLUMN bfd_prvdr_atndg_npi_type integer,
ADD COLUMN bfd_prvdr_oprtg_npi_type integer,
ADD COLUMN bfd_prvdr_othr_npi_type integer,
ADD COLUMN bfd_prvdr_rndrg_npi_type integer,
ADD COLUMN bfd_prvdr_rfrg_npi_type integer;

ALTER TABLE idr.claim_item_professional_nch
ADD COLUMN bfd_prvdr_rndrng_npi_type integer;

ALTER TABLE idr.claim_item_professional_ss
ADD COLUMN bfd_prvdr_rndrng_npi_type integer;

ALTER TABLE idr.claim_rx
ADD COLUMN bfd_prvdr_prscrbng_npi_type integer;
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31 changes: 31 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_institutional_nch.py
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Original file line number Diff line number Diff line change
Expand Up @@ -54,6 +54,7 @@
clm_rlt_ocrnc_clause,
provider_careteam_name_expr,
provider_last_or_legal_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -322,6 +323,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_atndg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_ATNDG)},
]

prvdr_rfrg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_RFRG},
Expand All @@ -333,6 +339,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rfrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RFRG)},
]

prvdr_othr_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_OTHR},
Expand All @@ -344,6 +355,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_othr_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_OTHR)},
]

prvdr_oprtg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_OPRTG},
Expand All @@ -355,6 +371,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_oprtg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_OPRTG)},
]

prvdr_rndrg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_RNDRNG},
Expand All @@ -366,6 +387,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

prvdr_srvc_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_SRVC},
Expand All @@ -377,6 +403,11 @@ class IdrClaimInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_srvc_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_SRVC)},
]

prvdr_blg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_BLG},
Expand Down
26 changes: 26 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_institutional_ss.py
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Original file line number Diff line number Diff line change
Expand Up @@ -57,6 +57,7 @@
clm_rlt_ocrnc_clause,
provider_careteam_name_expr,
provider_last_or_legal_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -318,6 +319,11 @@ class IdrClaimInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_atndg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_ATNDG)},
]

prvdr_rfrg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_RFRG},
Expand All @@ -329,6 +335,11 @@ class IdrClaimInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rfrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RFRG)},
]

prvdr_othr_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_OTHR},
Expand All @@ -340,6 +351,11 @@ class IdrClaimInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_othr_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_OTHR)},
]

prvdr_oprtg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_OPRTG},
Expand All @@ -351,6 +367,11 @@ class IdrClaimInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_oprtg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_OPRTG)},
]

prvdr_rndrg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_RNDRNG},
Expand All @@ -362,6 +383,11 @@ class IdrClaimInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

prvdr_blg_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_BLG},
Expand Down
6 changes: 6 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_item_institutional_nch.py
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Expand Up @@ -40,6 +40,7 @@
clm_child_query,
clm_query,
provider_careteam_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_hipps_code,
transform_default_string,
Expand Down Expand Up @@ -225,6 +226,11 @@ class IdrClaimItemInstitutionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrng_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

@override
@staticmethod
def table() -> str:
Expand Down
6 changes: 6 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_item_institutional_ss.py
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Expand Up @@ -44,6 +44,7 @@
clm_child_query,
clm_query,
provider_careteam_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_hipps_code,
transform_default_string,
Expand Down Expand Up @@ -236,6 +237,11 @@ class IdrClaimItemInstitutionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrng_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

# columns derived from v2_mdcr_clm_line_fiss_bnft_svg
bfd_clm_bnft_svg_ansi_grp_1_cd: Annotated[
str, {ALIAS: ALIAS_LINE_FISS_BFNT_FLATTENED}, BeforeValidator(transform_default_string)
Expand Down
6 changes: 6 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_item_professional_nch.py
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Original file line number Diff line number Diff line change
Expand Up @@ -37,6 +37,7 @@
clm_child_query,
clm_query,
provider_careteam_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -247,6 +248,11 @@ class IdrClaimItemProfessionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrng_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

@override
@staticmethod
def table() -> str:
Expand Down
6 changes: 6 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_item_professional_ss.py
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Original file line number Diff line number Diff line change
Expand Up @@ -39,6 +39,7 @@
clm_child_query,
clm_query,
provider_careteam_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -217,6 +218,11 @@ class IdrClaimItemProfessionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rndrng_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RNDRNG)},
]

@override
@staticmethod
def table() -> str:
Expand Down
11 changes: 11 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_professional_nch.py
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Original file line number Diff line number Diff line change
Expand Up @@ -47,6 +47,7 @@
clm_rlt_ocrnc_clause,
provider_careteam_name_expr,
provider_last_or_legal_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -179,6 +180,11 @@ class IdrClaimProfessionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rfrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RFRG)},
]

prvdr_srvc_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_SRVC},
Expand All @@ -190,6 +196,11 @@ class IdrClaimProfessionalNch(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_srvc_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_SRVC)},
]

# columns derived from v2_mdcr_clm_ocrnc_sgntr_mbr
bfd_clm_ncvrd_from_dt: Annotated[
date | None,
Expand Down
11 changes: 11 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_professional_ss.py
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Original file line number Diff line number Diff line change
Expand Up @@ -50,6 +50,7 @@
clm_rlt_ocrnc_clause,
provider_careteam_name_expr,
provider_last_or_legal_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -229,6 +230,11 @@ class IdrClaimProfessionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_rfrg_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_RFRG)},
]

prvdr_othr_prvdr_npi_num: Annotated[
str,
{COLUMN_MAP: "prvdr_npi_num", ALIAS: ALIAS_PRVDR_OTHR},
Expand All @@ -240,6 +246,11 @@ class IdrClaimProfessionalSs(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_othr_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_OTHR)},
]

# columns derived from v2_mdcr_clm_ocrnc_sgntr_mbr
bfd_clm_ncvrd_from_dt: Annotated[
date | None,
Expand Down
6 changes: 6 additions & 0 deletions apps/bfd-pipeline-idr/src/idr_pipeline/model/idr_claim_rx.py
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Original file line number Diff line number Diff line change
Expand Up @@ -42,6 +42,7 @@
clm_query,
provider_careteam_name_expr,
provider_last_or_legal_name_expr,
provider_npi_type_expr,
transform_default_date_to_null,
transform_default_string,
transform_null_date_to_min,
Expand Down Expand Up @@ -241,6 +242,11 @@ class IdrClaimRx(IdrBaseModel):
BeforeValidator(transform_default_string),
]

bfd_prvdr_prscrbng_npi_type: Annotated[
int | None,
{EXPR: provider_npi_type_expr(ALIAS_PRVDR_PRSCRBNG)},
]

@override
@staticmethod
def table() -> str:
Expand Down
8 changes: 8 additions & 0 deletions ...-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/OtherProfessionalCareTeam.java
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Original file line number Diff line number Diff line change
Expand Up @@ -5,6 +5,7 @@
import jakarta.persistence.AttributeOverride;
import jakarta.persistence.Column;
import jakarta.persistence.Embeddable;
import java.util.Optional;

/**
* Attending Provider History. NOTE - this is not currently in use anywhere (as far as I can tell)
Expand All @@ -13,9 +14,16 @@
@AttributeOverride(name = "providerNpiNumber", column = @Column(name = "prvdr_othr_prvdr_npi_num"))
@AttributeOverride(name = "providerName", column = @Column(name = "bfd_prvdr_othr_careteam_name"))
public class OtherProfessionalCareTeam extends ProviderHistoryBase {
@Column(name = "bfd_prvdr_othr_npi_type")
private Optional<Integer> npiType;

@Override
public CareTeamType getCareTeamType() {
return CareTeamType.OTHER;
}

@Override
protected NpiType getNpiType() {
return NpiType.fromNpiTypeCode(npiType);
}
}
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