Find a Doctor or Hospital general help
The Find a Doctor or Hospital online directory allows you to search for network doctors, hospitals and dentists. This information is collected from the provider's application at the time of credentialing and updated when new data is received from the provider. Data is subject to change without notice.
Here are a few areas to help with your search:
- First, choose how you would like to search. You may search by:
- The first three digits of your ID number, which can be found on your ID card or by calling 800-524-9242.
- Selecting your network, plan or product name. Choose the option that corresponds with the plan name shown on your ID card; or if you’re shopping, choose the option that corresponds with the product you’re considering.
- “Just looking.” Please note that using this search method will return providers across all plans.
Search definitions and tips
- 3-digit prefix – the first three alpha digits of your Wellmark ID number. The image of the ID card on the Provider Finder highlights where these digits can be found on your card
- Plan – The name shown on your member ID card. The image of the ID card of the Provider Finder highlights where your Plan name can be found on your card.
Product – if you’re shopping for a plan, you may search by product name to view Primary Care Providers available to you
- Network – a broad category plans and products. For example, HMO, PPO, POS
- PPO – Preferred Provider Organization. A network that includes a number of products and plans. Click ‘Show list’ to view PPO products and plans
- HMO – Health Maintenance Organization. A network that includes a number of products and plans. Click ‘Show list’ to view and select an option under HMO
- Indemnity Network – A network that includes the plan Classic Blue
- Point of Service Network – A network that includes a number of plans from which to select
- I’m just looking – use this option if you do not have, or are unable to provide, your 3-digit prefix or Plan, Product or Network name. Please note that your results will include providers among any number of plans.
- Address, city, and state or zip code – a required field that identifies the location in which you’d like to search for a provider.
- Distance – the number of miles from the location you entered in which you’d like to see results.
- What type of provider are you looking for? You may further refine your search by selecting or entering information into the these fields:
- No preference – selecting no preference instead of Primary Care Provider or Specialist will return search results that include all providers and specialists within the search criteria you’ve selected
- Primary care provider – Select this option if you are looking for: general practice, family practice, pediatrics, OB-Gyn, Physician Assistants, Nurse Practitioners
- Specialist – Non-primary care practitioners who are not assigned to patients during the enrollment process. Select this option to narrow your search by specialty.
- Provider’s name – If you know the name of the provider you’re looking for, you may enter last and first name.
Refining your search
Once you click search, you may find that that you have more results than you want, or the results are not what you’re looking for. You may refine your search in the following ways:
- Sort – you may sort your results by Distance (closest), in which results closest to the address you entered are listed first; Name (A-Z) in which your results are alphabetized; or Name (Z-A) in which your results are reverse alphabetized.
- Distance – decrease or increase the distance from your original location.
- Gender - By selecting male or female, your search will list all practitioners who meet your gender designation.
- Languages spoken - Language in which physicians are fluent.
- Accepting new patients - Shows "yes" if the provider will accept new patients to his or her practice location. The field will show "no" if the provider cannot accept new patients at a location, usually due to reaching his or her maximum capacity for scheduling appointments. You may wish to filter to see only providers who are accepting new patients.
- Quality Program - Wellmark recognizes clinicians participating in a Wellmark Quality Program.
- Board Certified or Accredited - Name of accreditations or certifications a provider could obtain based on his or her medical license or education, including the status of their accreditation or certification. See additional details under Results.
- Clinic or Medical Group Name – If you’re searching for a provider at a specific clinic or medical group, you may enter it to filter your results
- Hospital privileges – Names and cities of hospitals where the provider may have privileges to admit and/or see patients. You may enter a hospital at which providers have admitting privileges to refine your search.
In addition to the criteria you’ve selected, your search results may include:
- Create PDF Directory – you may create a printable PDF of your search results
- Map – click on the Map link next to a provider's address to generate an interactive map. If you entered a ZIP code as your starting address, the starting location in the turn-by-turn directions will be approximated. If you entered a complete address including street number and name, you will receive more accurate driving directions.
- Enrollment ID – The Wellmark enrollment number can be found on the details page and is used to identify a particular provider for the assignment of patients to a primary care provider or OB/GYN care provider
- Patient Reviews – ratings that patients have given a provider, ranging from ½ star to 5 stars. Comments and specific scores are often included
- Other locations – A listing of all locations at which a provider practices.
- Plans Accepted – a listing of all plans in which a provider participates
Board Certification – indicates that the physician (M.D., D.O. or D.P.M.) has successfully complet-ed the requirement of a particular specialty and has passed certification exams administered by the specialty board. The information is verified through the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).
- ABMS – The American Board of Medical Specialties, recognized as the "gold standard" in physician certification, works with 24 approved medical specialty boards in the development and implementation of standards in the ongoing evaluation and certification of physicians. www.abms.org
- AOA – American Osteopathic Association serves as the primary certifying body for Doctors of Osteopathic medicine (DO's), as well as the accrediting agency for all the osteopathic Medical Schools, to include federal authority to accredit hospitals and other health care facilities. www.osteopathic.org
- Accreditations - Depending on the type of facility, accreditations are awarded by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Centers for Medicare & Medicaid Services (CMS) and Det Norske Veritas Healthcare (DNVHC).
- JCAHO (now referred to as The Joint Commission) – The Joint Commission is an independent, not-for-profit organization that accredits and certifies more than 20,000 health care organizations, which is recognized nationally as a symbol of quality that reflects an organization's commitment to meeting certain performance standards. www.jointcomission.org
- CMS -
- HFAP – The Healthcare Facilities Accrediting Program is a nationally recognized accreditation program deeming authority by Medicare, which means they have been granted authority by the Centers for Medicare and Medicaid Services (CMS) to survey all hospitals for compliance with the Medicare Conditions of Participation and Coverage. www.hfap.org
- DNVHC - Det Norske Veritas Healthcare
To report a technical problem with Find a Doctor or Hospital, call us toll-free at 1-800-407-0267, Monday through Friday 7 a.m. - 5:30 p.m.
We recommend that you do not include personal information about your health or identity when reporting technical issues. For health-related questions, please contact the Customer Service number located on your member ID card, or in your enrollment materials.
If there were no providers listed in the specialty or criteria you were searching, you may want to consider one of these options:
- Check the spelling or different versions of the name you entered. For example, if you search for Liz Smith when our information refers to Elizabeth Smith, you may not find the results you're looking for. However, the Provider Finder may offer alternative spellings for name entries that return no results.
- Try changing your search radius.
- Revise your search, making sure the spelling, location, plan and all other information are correct.
- Give us a call. If you think your doctor is in a Wellmark network, but they don't appear in the results, call Customer Service using the number on your ID card to confirm. Or, you can call a Personal Health Assistant 24/7 at 1-800-724-9122 for help finding network providers.