Cristobal Cornejo Jr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

653 Issued in MA

Practice address

360 Huntington Ave
135 Forsyth Building
Boston, MA 02115-5005

Phone

(617) 373-8933

Fax

(617) 373-2601

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Wachusett Emergency Physicians, PC

  • Emergency Medicine Physician
  • Leominster, MA
  • NPI 1376553693
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659332799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 TRISTAN CT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016021314",
            "telephone_number": "774-261-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HUNTINGTON AVE",
            "address_2": "135 FORSYTH BUILDING",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155005",
            "telephone_number": "617-373-8933",
            "fax_number": "617-373-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "CRISTOBAL",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Cormier
• Stephen Bruce Corn, MD
• Elizabeth Cornacchio, RN
• Cornea Consultants - Kenneth R Kenyon MD PC
• Christine Michelle Cornejo
• Diana Camille Cornell, MD
• Lauren Janis Cornella, M.D.
• Kevin Matthew Cornett, MSN, RN
• Lindsey Corning, PT, DPT
• Alexandra Cornwall

• Medical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.