NPIMap

Individual provider Active NPI

Brett William Cornelius, PA-C

  • Physician Assistant
  • Edinboro, PA
National Provider Identifier
1083221675
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
450 Erie St
Edinboro, PA 16412-2200
Phone
(148) 734-1618
Fax
(148) 734-3102
NPI assigned
Sep 28, 2020
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 NU Primary

Addresses

Primary practice location

450 Erie St
Edinboro, PA 16412-2200

Mailing address

450 Erie St
Edinboro, PA 16412-2200
Phone (148) 734-1618

Other practice location 1

155 E State St
Albion, PA 16401-1347
Phone (814) 756-4917

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220127000071 PA Practitioner - Physician Assistant 8527474378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

2566 Haymaker Rd
Monroeville, PA 15146-3555

320 E N Ave
Pittsburgh, PA 15212-4756

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4282TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince May 13, 2024 Accepting new patients
Allegheny Clinic CurrentSince May 13, 2024 Accepting new patients
St Vincent Medical Education and Research Institute Inc CurrentSince Dec 27, 2021 Accepting new patients
Saint Vincent Medical Education and Research Institute Past Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

450 Erie St
Edinboro, PA 16412
Phone (814) 725-3750

2566 Haymaker Rd
Ste 306
Monroeville, PA 15146
Phone (412) 457-0100

4 Allegheny Ctr
Fl 7
Pittsburgh, PA 15212

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

Interoperability endpoints

  • Direct secure messaging: bcornelius448966@direct.ahn.org

Organizations & group practices 6

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 9

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1083221675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ERIE ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164122200",
            "telephone_number": "148-734-1618",
            "fax_number": "148-734-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ERIE ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164122200",
            "telephone_number": "148-734-1618",
            "fax_number": "148-734-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 E State St",
            "address_purpose": "LOCATION",
            "city": "Albion",
            "state": "PA",
            "postal_code": "164011347",
            "country_code": "US",
            "telephone_number": "814-756-4917",
            "fax_number": "814-756-5226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "BRETT",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinboro, PA

Sources for this page

Verify at the official NPI Registry.