Individual provider Active NPI

Roger Cornwall, M.D.

  • Orthopaedic Hand Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1376633826
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
35.092493 Issued in OH
Practice address
3333 Burnet Ave
ML 2017
Cincinnati, OH 45229-3026
Phone
(513) 636-4454
Fax
(513) 636-3928
NPI assigned
Oct 13, 2006
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD422463 PA
Pediatric Orthopaedic Surgery Physician 207XP3100X 35.092493 OH
Orthopaedic Hand Surgery Physician 207XS0106X 35.092493 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 2017
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 2017
Cincinnati, OH 45229-3026
Phone (513) 636-4454

Other identifiers 1

IdentifierTypeStateIssuer
100849367MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090319000484 OH Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 7810980570 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.092493OHMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center CurrentSince Apr 13, 2010 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Children's Surgical Associates LTD Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#2017
Cincinnati, OH 45229
Phone (513) 636-4454

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

5899 Harrison Ave
#6011
Cincinnati, OH 45248
Phone (513) 803-8200

7777 Yankee Rd
#16062
Liberty Township, OH 45044
Phone (513) 636-3200

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 3

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1376633826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 2017",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4454",
            "fax_number": "513-636-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 2017",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4454",
            "fax_number": "513-636-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD422463",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "OH",
            "license": "35.092493",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OH",
            "license": "35.092493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100849367",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.