Individual provider Active NPI

Eric G Cornidez, M.D.

  • Pain Medicine Physician
  • Tucson, AZ
National Provider Identifier
1679792527
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
37595 Issued in AZ
Practice address
4582 N 1St Ave
Ste 170
Tucson, AZ 85718-8602
Phone
(520) 318-6035
Fax
(520) 795-9953
NPI assigned
Apr 25, 2007
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 37595 AZ
Pain Medicine Physician 208VP0000X 37595 AZ Primary

Addresses

Primary practice location

4582 N 1St Ave
Ste 170
Tucson, AZ 85718-8602

Mailing address

4582 N 1St Ave
Ste 170
Tucson, AZ 85718-8602
Phone (520) 318-6035

Other identifiers 1

IdentifierTypeStateIssuer
524557MedicaidAZ

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
I20100628000183 AZ Practitioner - Pain ManagementPractitioner - Anesthesiology 8729119201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Stanford University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4582 N 1St Ave
Suite 170
Tucson, AZ 85718-8607
Phone (520) 318-6035

Merit-based Incentive Payment System (MIPS)

Final score
45.68 of 100Reported as group
Quality
40.49
Promoting interoperability
0
Improvement activities
30
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pisa ASC Holdco LLC CurrentSince Jan 22, 2020 Accepting new patients
Pain Institute of Southern Arizona Pisa PC Pain Medicine CurrentSince Dec 10, 2012 Accepting new patients
Pain Institute of Southern Arizona Pisa PC Pain Medicine CurrentSince Dec 10, 2012 Accepting new patients
Todd C Case MD PC Past Accepting new patients

Locations

120 W Calle de las Tiendas
Ste 2
Green Valley, AZ 85614

4582 N 1st Ave
Tucson, AZ 85718

4582 N 1st Ave
Ste 170
Tucson, AZ 85718
Phone (520) 505-3766

4741 E Camp Lowell Dr
Tucson, AZ 85712
Phone (520) 829-6620

4881 E Grant Rd
Tucson, AZ 85712
Phone (520) 829-6776

4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

Organizations & group practices 4

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1679792527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4582 N 1ST AVE",
            "address_2": "STE 170",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857188602",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 N 1ST AVE",
            "address_2": "STE 170",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857188602",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNIDEZ",
        "first_name": "ERIC",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "37595",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "37595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524557",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.