Active NPI
Mario Cornacchione, DO
- Geriatric Medicine (Family Medicine) Physician
- Allentown, PA
National Provider Identifier
1194807503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- OS005253L
- Practice address
- 1627 Chew St
Allentown, PA 18102-3648 - Phone
- (610) 969-3390
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | OS005253L | PA | Primary |
Addresses
Primary practice location
1627 Chew St
Allentown, PA 18102-3648
Mailing address
1200 Aleeda Blvd
Bear Creek Township, PA 18702-9611
Phone (570) 829-1095
Other practice location 1
1200 Aleeda Blvd
Bear Creek Township, PA 18702-9611
Phone (570) 829-1095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060320000671 | PA | Practitioner - Geriatric Medicine | 1850308644 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17 TH and Chew St
Allentown, PA 18102
Phone (610) 402-3390
Hospital & facility affiliations
- Lehigh Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS005253L | PA | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Northeastern Rehabilitation Associates, PC | Past | Accepting new patients | |
| Mercy Hospital of Nanticoke PA | Past | Accepting new patients |
Locations
1627 Chew St
Allentown, PA 18102
Phone (610) 969-2388
2100 Mack Blvd
Fl 4
Allentown, PA 18103
Interoperability endpoints
- mcornacchione107080@direct2.lvhn.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 and National Provider Directory roles.
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Hospital & facility affiliations 5
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": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1194807503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 ALEEDA BLVD",
"city": "BEAR CREEK TOWNSHIP",
"state": "PA",
"postal_code": "187029611",
"telephone_number": "570-829-1095",
"fax_number": "570-331-3584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 CHEW ST",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181023648",
"telephone_number": "610-969-3390"
}
],
"practiceLocations": [
{
"address_1": "1200 Aleeda Blvd",
"address_purpose": "LOCATION",
"city": "Bear Creek Township",
"state": "PA",
"postal_code": "187029611",
"country_code": "US",
"telephone_number": "570-829-1095",
"fax_number": "570-331-3584",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORNACCHIONE",
"first_name": "MARIO",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "PA",
"license": "OS005253L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.