Individual provider Active NPI

Dena L Cornelius, MD

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1366429086
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24408 Issued in AZ
Practice address
5111 N Scottsdale Rd Ste 108
Scottsdale, AZ 85250-7076
Phone
(602) 224-9218
Fax
(602) 224-0078
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24408 AZ Primary

Addresses

Primary practice location

5111 N Scottsdale Rd Ste 108
Scottsdale, AZ 85250-7076

Mailing address

5111 N Scottsdale Rd Ste 108
Scottsdale, AZ 85250-7076
Phone (602) 224-9218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090721000068 AZ Practitioner - Family Practice 8729160841 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24408AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Family Physicians Family Medicine CurrentSince Jun 1, 2009 Accepting new patients

Locations

4250 E Camelback Rd
Ste K100
Phoenix, AZ 85018
Phone (602) 224-9218

5111 N Scottsdale Rd
Ste 108
Scottsdale, AZ 85250
Phone (480) 219-6662

Organizations & group practices 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1366429086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N SCOTTSDALE RD STE 108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507076",
            "telephone_number": "602-224-9218",
            "fax_number": "602-224-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N SCOTTSDALE RD STE 108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507076",
            "telephone_number": "602-224-9218",
            "fax_number": "602-224-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "DENA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "24408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.