Individual provider Active NPI

Cornelia B Daly, M.D.

  • Gynecology Physician
  • Santa Monica, CA
National Provider Identifier
1174615389
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G54179 Issued in CA
Practice address
2001 Santa Monica Blvd Ste 970W
Santa Monica, CA 90404-2199
Phone
(310) 829-7878
Fax
(310) 453-5586
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G54179 CA
Gynecology Physician 207VG0400X G54179 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 970W
Santa Monica, CA 90404-2199

Mailing address

2001 Santa Monica Blvd
#970-W
Santa Monica, CA 90404-2199
Phone (310) 829-7878

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdaly473276@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20110525000686 CA Practitioner - Obstetrics/Gynecology 2163608225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54179CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Sep 3, 2019 Accepting new patients
Frumovitz, Matsunaga, Daly, Ross, Thordarson, Vogel, MD'S - a Med Corp Specialist CurrentSince Feb 1, 1991 Accepting new patients
Providence Saint Johns Medical Foundation Specialist CurrentSince Sep 3, 2019 Accepting new patients
Saint John'S Health Clinic Specialist Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2001 Santa Monica Blvd
Ste 970W
Santa Monica, CA 90404
Phone (310) 829-7272

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2001 Santa Monica Blvd
Ste 970
Santa Monica, CA 90404
Phone (310) 829-7878

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1174615389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "#970-W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042199",
            "telephone_number": "310-829-7878",
            "fax_number": "310-453-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 970W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042199",
            "telephone_number": "310-829-7878",
            "fax_number": "310-453-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "CORNELIA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G54179",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G54179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdaly473276@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2001 Santa Monica Blvd Ste 970W",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.