Kelly Joy Hunter Cornelius

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

032959 Issued in NY

Practice address

101 Hospital Rd
Patchogue, NY 11772-4870

Phone

(631) 228-5801

NPI assigned

Jan 3, 2025

Sex

Female

Sole proprietor

Yes

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: kcornelius695515@nyumc.direct-ci.com

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY, Single Specialty

  Medicare reassignment Care Compare group NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

• NYU Langone Hospitals

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Patchogue, NY
  • NPI 1013724061

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Patchogue, NY
  • NPI 1831910355
  Care Compare affiliation

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1689483687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BAYVIEW AVE",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333933",
            "telephone_number": "631-260-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-228-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "KELLY JOY",
        "middle_name": "HUNTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "032959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Conway, PHARMACIST
• Christina Cooke, LMT
• Mary C Cooke, RD
• Stephanie Cooke
• Shannon Joan Cordova
• Dawn Marie Corrigan, LPN
• Barbara Cosentino, CASAC
• Laura N Costello, LPN
• Country Foot Care Podiatry PLLC
• County of Suffolk

• Surgical Physician Assistant in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.