Rachel I Kornik, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

54704-20 Issued in WI

Practice address

53 Fairfax Rd
Saint Albans, VT 05478-4405

Phone

(802) 582-4900

Fax

(802) 782-8239

NPI assigned

May 13, 2008

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Dermatology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital - Madison Hospital, Madison, WI, CCN 520083
• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041
• SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkornik403988@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846

  Dermatology

  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation
• SSM Health Care of Wisconsin Inc

  dba SSM Health St Clare Hospital-Baraboo

  • General Acute Care Hospital
  • Baraboo, WI
  • NPI 1386641207
  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  dba SSM Health St. Mary's Hospital-Madison

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1063689727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1234",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011234",
            "telephone_number": "802-582-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 FAIRFAX RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054784405",
            "telephone_number": "802-582-4900",
            "fax_number": "802-782-8239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UW health Dept of Dermatology 1 S. Park St",
            "address_2": "Administrative office 7th floor",
            "address_purpose": "LOCATION",
            "city": "madison",
            "state": "WI",
            "postal_code": "53715",
            "country_code": "US",
            "telephone_number": "608-287-2658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "752 N High Point Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537172236",
            "country_code": "US",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNIK",
        "first_name": "RACHEL",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VT",
            "license": "042.0015116",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "54704-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063689727",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkornik403988@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rkornik403988@direct-ehr-ssmhc.com",
            "address_1": "752 N High Point Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537172236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "752 N High Point Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537172236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin J King
• Ian Kirkland
• Helen Klemchuk, PHD
• David S Knightes, RPH
• Kelli Kolenich
• KPH Healthcare Services, Inc. (Kinney Drugs #18)
• Bethany Erin Kulikowski, COTA/L
• Marc S Kutler, MD
• Mallorie Mae Kutzner, MS, LCMHC
• Blaine Matthew Lachance, LCMHC

• Dermatology Physician in Saint Albans, VT
• Providers in Saint Albans, VT by specialty
• Dermatology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.