Organization Active NPI

Dr. James V. Cornetta LTD

  • Optometrist
  • Portsmouth, VA
National Provider Identifier
1194716928
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1689665861 Issued in VA
Legal business name
DR. JAMES V. CORNETTA LTD
Practice address
226 Fort LN
Portsmouth, VA 23704-2220
Phone
(757) 393-6131
Fax
(757) 393-0976
NPI assigned
Nov 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. James V Cornetta, ODNPI 1689665861
Title
Owner
Phone
(757) 393-6131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1689665861 VA Primary

Addresses

Primary practice location

226 Fort LN
Portsmouth, VA 23704-2220

Mailing address

226 Fort LN
Portsmouth, VA 23704-2220
Phone (757) 393-6131

Other identifiers 1

IdentifierTypeStateIssuer
200002OtherVAOPTIMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050218000660 VA Part B Supplier - Clinic/Group Practice 1254383136 Receives reassigned benefits from 3 practitioners
Practice locations: Portsmouth, VA
O20100930074185 VA DME Supplier - Physician - Optometrist 1254383136 Practice locations: Portsmouth, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dr James V Cornetta LTD226 Fort LN, Portsmouth, VA 23704-2220(757) 393-6131 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2006

National Provider Directory

National Provider Directory

Locations

226 Fort Ln
Portsmouth, VA 23704
Phone (757) 393-0976

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1194716928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FORT LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042220",
            "telephone_number": "757-393-6131",
            "fax_number": "757-393-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 FORT LN",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042220",
            "telephone_number": "757-393-6131",
            "fax_number": "757-393-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAMES V. CORNETTA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "CORNETTA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-393-6131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "1689665861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "200002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.