Individual provider Active NPI

Suzanne Renee Cornelius, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1316050875
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8501 Harcourt Rd
Indianapolis, IN 46260-2046
Phone
(317) 875-9105
Fax
(317) 808-8802
NPI assigned
Aug 17, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8501 Harcourt Rd
Indianapolis, IN 46260-2046

Mailing address

8501 Harcourt Rd
Indianapolis, IN 46260-2046
Phone (317) 875-9105

Other identifiers 3

IdentifierTypeStateIssuer
000000345959OtherANTHEM HEALTH PLAN
P00301231OtherINRR MEDICARE
300006437MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001414 IN Practitioner - Physician Assistant 4789644972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Practice addresses (Care Compare)

1115 Ronald Reagan Pkwy
Suite 224
Avon, IN 46123-6911
Phone (317) 875-9105

8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone (317) 802-2000

8501 Harcourt Rd
Indianapolis, IN 46260-2046
Phone (317) 875-9105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beltway Surgery Centers LLC Current Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Apr 1, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Apr 1, 2025 Accepting new patients
Indiana University Health Ambulatory Surgery Centers, LLC Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Orthopaedics-Indianapolis, Inc Physician Assistant Past Accepting new patients

Locations

9070 E 56th St
Ste 400
Brownsburg, IN 46112
Phone (317) 268-3600

13914 Southeastern Pkwy
Ste 201
Fishers, IN 46037
Phone (317) 275-1999

8450 Northwest Blvd
Indianapolis, IN 46278

8501 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 471-4339

17219 Foundation Pkwy
Westfield, IN 46074
Phone (314) 707-8620

Interoperability endpoints

  • Direct secure messaging: scorneli@direct.iuhealth.org
  • Direct secure messaging: suzanne.cornelius.1@29985.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1316050875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602046",
            "telephone_number": "317-875-9105",
            "fax_number": "317-875-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602046",
            "telephone_number": "317-875-9105",
            "fax_number": "317-808-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "SUZANNE",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTH PLAN",
            "identifier": "000000345959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00301231",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006437",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.