Individual provider Active NPI

Kristine S Corkum, M.D.

  • Pediatric Surgery Physician
  • Aurora, CO
National Provider Identifier
1427492289
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
DR.0064377 Issued in CO
Practice address
13123 E 16TH Ave # 323
Aurora, CO 80045-7106
Phone
(720) 777-6571
NPI assigned
Apr 24, 2013
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125062642 IL
Pediatric Surgery Physician 2086S0120X DR.0064377 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave # 323
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

420 E Superior St
Rubloff 12th Floor
Chicago, IL 60611-4494
Phone (312) 503-7975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220915000900 CO Practitioner - General SurgeryPractitioner - Pediatric Medicine 5698070126 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125062642ILMDSurgery Physician
DR.0064377COMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Sep 15, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 1, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 1, 2022 Accepting new patients
University Physicians Incorporated Surgery Current Accepting new patients
University Physicians Incorporated Surgery CurrentSince Sep 15, 2022 Accepting new patients
Children's Hospital Colorado Past Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13123 E 16th Ave
#323
Aurora, CO 80045
Phone (702) 777-4531

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: kcorkum228533@direct.childrenscolorado.org
  • Direct secure messaging: kcorkum230122@direct.dhha.org

Organizations & group practices 8

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1427492289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # 323",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-6571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E Superior St",
            "address_2": "Rubloff 12th Floor",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114494",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "fax_number": "312-503-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORKUM",
        "first_name": "KRISTINE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-09-07",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125062642",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CO",
            "license": "DR.0064377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.