Individual provider Active NPI

Cory James Demino, MD

  • Student in an Organized Health Care Education/Training Program
  • Erie, PA
National Provider Identifier
1487276648
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
12983 Issued in GA
Practice address
300 State St Ste 205
Erie, PA 16507-1429
Phone
(814) 456-6022
NPI assigned
May 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 12983 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X MT220034 PA

Addresses

Primary practice location

300 State St Ste 205
Erie, PA 16507-1429

Mailing address

3600 Forbes Avenue
Forbes Tower Plaza Level Suite 140
Pittsburgh, PA 15213
Phone (412) 647-5815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210720001518 GA Order and Referring Only - General SurgeryPractitioner - General Surgery 4981007572

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT220034PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Therapeutics Inc PastSince Dec 1, 2017 Accepting new patients
Hand, Microsurgery and Reconstructive Orthopaedics, LLP PastSince Jun 24, 2019 Accepting new patients

Organizations & group practices 2

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": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1487276648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE",
            "address_2": "FORBES TOWER PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "412-647-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST STE 205",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071429",
            "telephone_number": "814-456-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMINO",
        "first_name": "CORY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "12983",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT220034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.