Individual provider Active NPI

Scott Forrest Corneal, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • St Augustine, FL
National Provider Identifier
1215966577
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
OS 9769 Issued in FL
Practice address
1301 Plantation Island Dr S
Suite 402a
St Augustine, FL 32080-3108
Phone
(904) 471-4744
Fax
(904) 471-4745
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X OS 9769 FL Primary

Addresses

Primary practice location

1301 Plantation Island Dr S
Suite 402a
St Augustine, FL 32080-3108

Mailing address

1301 Plantation Island Dr S
Suite 402a
St Augustine, FL 32080-3108
Phone (904) 471-4744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060802000458 FL Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 5496768707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
University of New England, College of Osteo Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 Plantation Island Dr S
Suite 402a
St Augustine, FL 32080-3118
Phone (904) 471-4744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 9769FLMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Pain Solutions, PL Pain Medicine CurrentSince May 16, 2006 Accepting new patients
Gwinnett Sports Medicine & Orthopaedic Surgery PC PastSince Aug 1, 2005 Accepting new patients

Locations

1301 Plantation Island Dr S
Ste 402A
Saint Augustine, FL 32080
Phone (904) 471-4744

Organizations & group practices 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1215966577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-471-4744",
            "fax_number": "904-471-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 402A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-471-4744",
            "fax_number": "904-471-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEAL",
        "first_name": "SCOTT",
        "middle_name": "FORREST",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS 9769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.