Cornell Orthotics and Prosthetics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CORNELL ORTHOTICS AND PROSTHETICS, INC

Practice address

100 Cummings Ctr
Suite 207H
Beverly, MA 01915-6115

Phone

(978) 922-2866

Fax

(978) 922-0277

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Keith Donald Cornell, C.P.

Title

President

Phone

(978) 922-2866

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Cornell Orthotics and Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Danvers, MA
  • NPI 1841387586

  6901923861

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Cornell Orthotics and Prosthetics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cornell Orthotics and Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Danvers, MA
  • NPI 1841387586
  NPD tax ID

Locations

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1366444739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 207H",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-922-2866",
            "fax_number": "978-922-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 207H",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-922-2866",
            "fax_number": "978-922-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL ORTHOTICS AND PROSTHETICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-922-2866",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "700854",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527975",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS MEDICARE PREFERRED",
            "identifier": "801259",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "801259",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "8853",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "355654",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Corcoran, CCC-SLP
• Melinda M. Corey
• David C Cormier, D.D.S.
• Margaret Cornacchio
• Taicha Cornelio, BACHELOR OF ARTS
• Cornerstone Caregiving East LLC
• William J Cornetta III, M.D.
• Heather Marie Correll, MASTERS
• James R Corrente, DPT, PT, ATC
• Amy Elisabeth Corveleyn, MSW

• Prosthetic/Orthotic Supplier in Beverly, MA
• Providers in Beverly, MA by specialty
• Prosthetic/Orthotic Supplier in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.