Carol J Cornejo, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00031941 Issued in WA

Practice address

7315 212TH St SW
Suite 201
Edmonds, WA 98026-7610

Phone

(425) 778-8116

Fax

(425) 775-9526

NPI assigned

Mar 16, 2006

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

Enrolled in WA

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

Specialty

General Surgery

Education

University of California, San Francisco School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carol.cornejo.p77@direct.proliance.nextgenshare.com

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.

• Proliance Surgeons Inc P S

  dba Proliance Surgeons Orthopedic Specialists of Seattle

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  dba Proliance Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons Inc., P.S.

  dba Proliance Surgical Specialists of Edmonds

  • Surgery Physician
  • Edmonds, WA
  • NPI 1073540894
  NPD
• Proliance Surgeons, Inc., P.S.

  dba Proliance South Seattle Otolaryngology

  • Otolaryngology Physician
  • Burien, WA
  • NPI 1114108784
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1316916927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW",
            "address_2": "SUITE 201",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-778-8116",
            "fax_number": "425-775-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "CAROL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00031941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8234551",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Corbeille, ND
• Tami J Corbett, ARNP
• Core Accident & Injury Clinic LLC (CORE Accident & Injury)
• Core Accident & Injury Clinic LLC
• H Gary Corless, DPM
• Cornerstone Prosthetics and Orthotics Inc
• Judyline Padilla Corpuz, LMHCA
• Rosalie Kathryn Corrigan
• Dennis Lee Corum, LMP
• Rachel Ferguson Cory, RN

• Surgery Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.