Appendix-2_Required Data Elements~3.pdf
PDF 92 KB Posted
- Attached to
- T2792 - Health Care Profile System State and local contract opportunity
- Solicitation number
- 26DPP01246
- Issued by
- New Jersey
About this file
This appendix document outlines the required data elements for the Health Care Profile System managed by the New Jersey Division of Consumer Affairs (DCA). The system maintains comprehensive professional information for licensed healthcare providers, including licensee identities, contact details, license numbers, issuance dates, and licensure history. The data elements encompass clinical qualifications such as medical specialty, medical school information, graduation dates, post-graduate training including internships and residencies, board certifications and subcertifications, and teaching appointments. Additionally, the system captures practice-related information including practice addresses, health plan affiliations, languages spoken, and hospital privileges.
The system also documents regulatory and disciplinary information sourced from the DCA, American Medical Association (AMA), American Osteopathic Association (AOA), and individual doctors. These elements include medical malpractice payment history, New Jersey and out-of-state disciplinary actions, license limitations and restrictions, hospital privilege restrictions, and criminal convictions. Data origination varies by field, with some information maintained solely by DCA, some sourced from AMA or AOA databases, and some updateable by licensed physicians themselves. The system tracks all field updates and update history to maintain data integrity and enable disputes, with a last update date displayed for all information to ensure transparency regarding data currency.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Appendix-4_Profile Letters Email~1.pdf | ||
| Appendix-3_Active Profile Count~1.pdf | ||
| Appendix-5_Paper Survey~1.pdf | ||
| T2792 State-Supplied Price Sheet 01.22.2026~2.xlsx | XLSX spreadsheet | |
| T2792 Bid Solicitation 01.22.2026~2.docx | DOCX document | |
| Appendix-3a_Active Profile Count~1.pdf | ||
| Appendix-10_About Us~1.pdf | ||
| Combined State of New Jersey Standard Terms and Conditions~2.pdf | ||
| Appendix-8_FAQ~1.pdf | ||
| Standard Procurement Forms Packet~2.pdf | ||
| Appendix-6_Requirement Checklist~1.pdf | ||
| T2792 Pre-Quote Conference 01.22.2026~2.pptx | PPTX presentation | |
| Appendix-11_Practitioner login~1.pdf | ||
| Appendix-9_Disclaimer~1.pdf | ||
| Appendix-7_HCP Find Page~1.pdf | ||
| Appendix-1_New Jersey Health Care Information Act~3.pdf |
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Text version
Appendix 2
Appendix 2
Field Name Origination Notes Licensee Name DCA Mailing Address DCA Updateable by Doctor.
Contact information (Phone, Fax & E-Mail) DCA Updateable by Doctor.
License Number DCA NJ Issuance Date DCA Year First Licensed AMA, AOA or Doctor Updateable by Doctor.
Specialty (Area of Practice) AMA, AOA or Doctor Doctor selects from list.
Medical School DCA, AMA or AOA Date of Graduation DCA, AMA or AOA Post Graduate Training (internships, residencies, fellowships) AMA, AOA or Doctor Updateable by Doctor.Sponsor, Completion Date and Specialty.
Board Certifications DCA, AMA, AOA or Doctor Doctor may only update self reported certifications.
Board Subcertifications DCA, AMA, AOA or Doctor Doctor may only update self reported subcertifications.
Practice Information ( Address and other information) DCA or Doctor Optometrist locations are not updateable by Doctor.
Health Plan Contracts or Other Affiliations Doctor Updateable by Doctor.
Languages spoken Doctor Updateable by Doctor.
Medical Malpractice Payment Information DCA or Doctor DCA data can only be disputed by Doctor.
NJ Disciplinary Actions (Date, Action and Agency) DCA or Doctor DCA data can only be disputed by Doctor.
NJ License Limitations and Restrictions DCA or Doctor DCA data can only be disputed by Doctor.
Out of State Disciplinary Actions (Date, Action and Agency) DCA or Doctor DCA data can only be disputed by Doctor. Includes Out of State limitations and restrictions.
Hospital and Health Care Facility Privilege Restrictions DCA or Doctor DCA data can only be disputed by Doctor.
Criminal Convictions (Date, Jurisdiction and Description) DCA or Doctor DCA data can only be disputed by Doctor.
Teaching Appointments (School and Appointment Dates) Doctor Updateable by Doctor.
Hospital Privileges Doctor Updateable by Doctor.
Field and update history for all information System Last update date displayed for all information.
History required to determine which data to display.
Key:
DCA - Originates from Division databases.
AMA - American Medical Association database.
AOA - American Osteopathic Association database.
Doctor - Submitted by licensee.
System - Created by application.
DCA Minimum Required Data Elements
Appendix 2
File details come from the government source that posted it. Updated .