Individual provider Active NPI

Erin M. Cornelius, PA-C

  • Physician Assistant
  • Arvada, CO
National Provider Identifier
1073603650
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1704 Issued in CO
Practice address
7950 Kipling St
Ste 101
Arvada, CO 80005-3923
Phone
(303) 425-4680
Fax
(303) 425-1616
NPI assigned
Oct 13, 2006
Last updated
Feb 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1704 CO Primary

Addresses

Primary practice location

7950 Kipling St
Ste 101
Arvada, CO 80005-3923

Mailing address

1707 Cole Blvd
Ste 100
Golden, CO 80401-3220
Phone (303) 716-8018

Other identifiers 1

IdentifierTypeStateIssuer
72959541MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002010 NE Practitioner - Physician Assistant 4082645320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

2631 S 70TH St
Neurology Associates
Lincoln, NE 68506-2960
Phone (402) 483-7226

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1704COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Sep 11, 2023 Accepting new patients
Neurology Associates, P.C. Past Accepting new patients

Locations

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

2631 S 70th St
Lincoln, NE 68506
Phone (402) 483-7226

Interoperability endpoints

  • Direct secure messaging: ecornelius154767@hisp.bryanhealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IAJFAA

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1073603650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 COLE BLVD",
            "address_2": "STE 100",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804013220",
            "telephone_number": "303-716-8018",
            "fax_number": "303-763-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 KIPLING ST",
            "address_2": "STE 101",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800053923",
            "telephone_number": "303-425-4680",
            "fax_number": "303-425-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "ERIN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72959541",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.