Christine Michelle Cornejo

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

278249 Issued in MA

Practice address

221 Longwood Ave
Boston, MA 02115

Phone

(617) 732-5500

NPI assigned

Apr 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1073931390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Spruce St",
            "address_2": "2 Maloney Building, HUP",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044211",
            "country_code": "US",
            "telephone_number": "601-507-4376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Spruce St",
            "address_2": "2 Maloney Building, HUP",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044211",
            "country_code": "US",
            "telephone_number": "601-507-4376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "CHRISTINE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "278249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin C Cormier, RPT
• Hannah Cormier
• Stephen Bruce Corn, MD
• Elizabeth Cornacchio, RN
• Cornea Consultants - Kenneth R Kenyon MD PC
• Cristobal Cornejo Jr., PA-C
• Diana Camille Cornell, MD
• Lauren Janis Cornella, M.D.
• Kevin Matthew Cornett, MSN, RN
• Lindsey Corning, PT, DPT

• Dermatology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.