Sara J. Cornell, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS016217 Issued in PA

Practice address

906 Route 940
Pocono Lake, PA 18347-7891

Phone

(570) 991-2109

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, FL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Philadelphia College of Osteopathic Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: saracornell@tdh.allscriptsdirect.net

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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  Psychologist

  NPD
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  NPD

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1285851576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 767",
            "city": "POCONO LAKE",
            "state": "PA",
            "postal_code": "183470767",
            "telephone_number": "570-991-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 ROUTE 940",
            "city": "POCONO LAKE",
            "state": "PA",
            "postal_code": "183477891",
            "telephone_number": "570-991-2109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 US Highway 1 Unit 102B",
            "address_purpose": "LOCATION",
            "city": "North Palm Beach",
            "state": "FL",
            "postal_code": "334083879",
            "country_code": "US",
            "telephone_number": "570-242-1768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Jupiter Lakes Boulevard",
            "address_2": "Suite 2315C",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "33458",
            "country_code": "US",
            "telephone_number": "570-991-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "SARA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2024-06-04",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016217",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101894788",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Pocono Lake, PA
• Providers in Pocono Lake, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.