Individual provider Active NPI

Cornel C Van Gorp, MD

  • Orthopaedic Surgery Physician
  • Bryan, OH
National Provider Identifier
1255317475
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35.075876 Issued in OH
Practice address
442 W High St Ste 3
Bryan, OH 43506-1681
Phone
(419) 636-4517
Fax
(419) 636-6438
NPI assigned
Dec 20, 2005
Last updated
Aug 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35.075876 OH Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 35075876 OH

Addresses

Primary practice location

442 W High St Ste 3
Bryan, OH 43506-1681

Mailing address

5052 N Clinton St
Fort Wayne, IN 46825-5822
Phone (260) 484-8551

Other identifiers 1

IdentifierTypeStateIssuer
157068102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060912000653 OH Practitioner - Orthopedic Surgery 2769372325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Ohio, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

515 Union Ave
Suite 167
Dover, OH 44622-3005
Phone (330) 343-3335

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35075876OHMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Physician Services, LLC Orthopaedic Surgery CurrentSince Sep 25, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University of Utah Orthopedic Consultants Orthopaedic Surgery Past Accepting new patients
Fauster Cameron Inc. Past Accepting new patients
University of Toledo Physicians LLC Orthopaedic Surgery Past Accepting new patients

Locations

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

515 Union Ave
Ste 167
Dover, OH 44622
Phone (330) 343-3335

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.

Hospital & facility affiliations 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1255317475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 W HIGH ST STE 3",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061681",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GORP",
        "first_name": "CORNEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.075876",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OH",
            "license": "35075876",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157068102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.