Individual provider Active NPI

David S. Cornelder, D.O.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1174759740
Registry record updated Oct 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4119 Issued in IA
Practice address
1801 Hickman Rd
Des Moines, IA 50314-1505
Phone
(515) 282-2200
Fax
(515) 282-2332
NPI assigned
Jun 9, 2009
Last updated
Oct 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4119 IA Primary

Addresses

Primary practice location

1801 Hickman Rd
Des Moines, IA 50314-1505

Mailing address

1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20121024000792 IA Practitioner - Emergency MedicinePractitioner - Family Practice 8820248032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4119IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Sep 11, 2017 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Mahaska County Hospital Current Accepting new patients
Mahaska County Hospital Family Medicine CurrentSince May 28, 2023 Accepting new patients
Broadlawns Medical Center CurrentSince Sep 11, 2017 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1229 C Ave E
Oskaloosa, IA 52577
Phone (641) 672-3100

201 Trueblood Ave
Oskaloosa, IA 52577
Phone (641) 672-3360

Interoperability endpoints

  • Direct secure messaging: cornelder.david@cynchealthdsm.org
  • Direct secure messaging: dcornelder26811@direct.unitypoint.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286755200000",
    "number": "1174759740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2200",
            "fax_number": "515-282-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2200",
            "fax_number": "515-282-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELDER",
        "first_name": "DAVID",
        "middle_name": "S.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2010-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "4119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.