Individual provider Active NPI

Harold Kornylak, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Virginia Beach, VA
National Provider Identifier
1043385370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
0102036958 Issued in VA
Practice address
1432 E Bay Shore Dr
Virginia Beach, VA 23451-3760
Phone
(757) 491-3294
Fax
(480) 275-3481
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 0102036958 VA Primary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DOS1022 HI

Addresses

Primary practice location

1432 E Bay Shore Dr
Virginia Beach, VA 23451-3760

Mailing address

1432 E Bay Shore Dr
Virginia Beach, VA 23451-3760
Phone (757) 491-3294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000669 VA Practitioner - Osteopathic Manipulative Medicine 6901072503 Practice locations: Virginia Beach, VA

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1432 E Bay Shore Dr
Virginia Beach, VA 23451-3760
Phone (757) 491-3294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DOS1022HIMDNeuromusculoskeletal Medicine & OMM Physician
0102036958VAMDNeuromusculoskeletal Medicine & OMM Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043385370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 E BAY SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513760",
            "telephone_number": "757-491-3294",
            "fax_number": "480-275-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 E BAY SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513760",
            "telephone_number": "757-491-3294",
            "fax_number": "480-275-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNYLAK",
        "first_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "VA",
            "license": "0102036958",
            "primary": true
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "HI",
            "license": "DOS1022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.