Individual provider Active NPI

Brielle Lauren Cornelius

  • Nurse Practitioner
  • Olean, NY
National Provider Identifier
1285360313
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
349997 Issued in NY
Practice address
623 Main St
Olean, NY 14760-1532
Phone
(716) 372-4212
NPI assigned
Jul 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 349997 NY Primary

Addresses

Primary practice location

623 Main St
Olean, NY 14760-1532

Mailing address

623 Main St
Olean, NY 14760-1532
Phone (814) 203-1194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221010000385 NY Practitioner - Nurse Practitioner 7911383302 Reassigns benefits to 2 organizations
I20251112003481 PA Practitioner - Nurse Practitioner 7911383302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

424 Church St
Nashville, TN 37219-2301

703 King St
Olean, NY 14760-3009

Hospital & facility affiliations

  • Olean General Hospital Hospital, Olean, NY, CCN 330103
  • Jones Memorial Hospital Hospital, Wellsville, NY, CCN 330096
  • Upmc Cole Hospital, Coudersport, PA, CCN 391313
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Matrix Medical of New York PC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Nephrology Services Medical Group of Olean & Bradford, PC CurrentSince Aug 8, 2022 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

515 Main St
Olean, NY 14760
Phone (716) 373-2600

623 Main St
Olean, NY 14760
Phone (716) 372-4212

623 Main St
Ste 200
Olean, NY 14760
Phone (716) 372-4212

100 S Juniper St
Fl 3
Philadelphia, PA 19107
Phone (267) 999-9534

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1285360313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601532",
            "telephone_number": "814-203-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601532",
            "telephone_number": "716-372-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "BRIELLE",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "349997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.