Individual provider Active NPI

Judith Cornely, DO

  • Pediatrics Physician
  • Boynton Beach, FL
National Provider Identifier
1285950667
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS 10857 Issued in FL
Practice address
2828 S Seacrest Blvd
Suite 214
Boynton Beach, FL 33435-7944
Phone
(561) 734-1888
Fax
(561) 734-8274
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS 10857 FL Primary

Addresses

Primary practice location

2828 S Seacrest Blvd
Suite 214
Boynton Beach, FL 33435-7944

Mailing address

2828 S Seacrest Blvd
Suite 214
Boynton Beach, FL 33435-7944

Other practice location 1

4400 N State Road 7
Lauderdale Lakes, FL 33319-5862
Phone (954) 486-8020

Other identifiers 1

IdentifierTypeStateIssuer
002037400MedicaidFL

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
I20111102000530 FL Practitioner - Pediatric Medicine 3577736891 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 10857FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince Oct 14, 2011 Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince Oct 14, 2011 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 1, 2012 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 1, 2012 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Current Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

Interoperability endpoints

  • Direct secure messaging: judith.cornely.1@14931.direct.athenahealth.com

Organizations & group practices 7

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": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1285950667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 S SEACREST BLVD",
            "address_2": "SUITE 214",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 S SEACREST BLVD",
            "address_2": "SUITE 214",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357944",
            "telephone_number": "561-734-1888",
            "fax_number": "561-734-8274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 N State Road 7",
            "address_purpose": "LOCATION",
            "city": "Lauderdale Lakes",
            "state": "FL",
            "postal_code": "333195862",
            "country_code": "US",
            "telephone_number": "954-486-8020",
            "fax_number": "954-486-8983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELY",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS 10857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002037400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.