Alexandra Gately Cornell, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

161586 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Ohsu Pediatrics
Portland, OR 97239-3011

Phone

(503) 494-5476

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1164580486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU PEDIATRICS",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU PEDIATRICS",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "ALEXANDRA",
        "middle_name": "GATELY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "249817",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NH",
            "license": "15287",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OR",
            "license": "161586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32000767",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selena Marie Cornelius
• Richard A Corneliuz, CPFT
• Cornell Eyecare Group, Inc
• Cornell Family Dental
• Cornell Family Medicine
• Corner Health Medical Group Northwest, P.C.
• Cornerstone Care Option
• Cornerstone Care Option, Inc.
• Cornerstone Natural Medicine LLC
• Estonia Cornett

• Pediatric Pulmonology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Pulmonology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.