Individual provider Active NPI

Matthew C Cornelius, M.D.

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1619946969
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
24409 Issued in AZ
Practice address
1300 N 12TH St Ste 320
Phoenix, AZ 85006-2848
Phone
(602) 521-3605
Fax
(602) 521-3601
NPI assigned
Mar 17, 2006
Last updated
Apr 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 24409 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 320
Phoenix, AZ 85006-2848

Mailing address

1300 N 12TH St Ste 320
Phoenix, AZ 85006-2848
Phone (602) 521-3605

Other identifiers 1

IdentifierTypeStateIssuer
480020MedicaidAZ

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
I20060605000205 AZ Practitioner - Psychiatry 4486665510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arizona College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

1300 N 12TH St
Suite 320
Phoenix, AZ 85006-2858
Phone (602) 839-6800

1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2849
Phone (602) 839-3927

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24409AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 312
Phoenix, AZ 85006
Phone (602) 279-5055

1300 N 12th St
Ste 320
Phoenix, AZ 85006
Phone (602) 521-3050

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

925 E McDowell Rd
Fl 4
Phoenix, AZ 85006
Phone (602) 839-6880

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1619946969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 320",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-521-3605",
            "fax_number": "602-521-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 320",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-521-3605",
            "fax_number": "602-521-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "24409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480020",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.