Stephanie J Corneliussen, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

100 4TH St S
Fargo, ND 58103-1929

Phone

(701) 234-3100

NPI assigned

Mar 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1255605762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031929",
            "telephone_number": "701-234-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUSSEN",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16885",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Corbett
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• Jessica Lee Cornelius
• Scott Corneliussen, ATC
• Corner Medical LLC
• Cornerstone Caregiving East LLC
• Cornerstone Dental Group LLC
• Cornerstone Residential Services
• Cornervine Counseling, PLLC

• Psychologist in Fargo, ND
• Providers in Fargo, ND by specialty
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.

Verify at the official NPI Registry.