Philip Peter Corneliuson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19857 Issued in CA

Practice address

5475 N Fresno St Ste 103
Fresno, CA 93710-8333

Phone

(559) 261-0185

Fax

(559) 261-2386

NPI assigned

Mar 28, 2013

Sex

Male

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Philip P Corneliuson DDS Inc

  • Dentist
  • Fresno, CA
  • NPI 1205914470
  NPD (past) Authorized official

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1699018671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 N FRESNO ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108333",
            "telephone_number": "559-261-0185",
            "fax_number": "559-261-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 N FRESNO ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108333",
            "telephone_number": "559-261-0185",
            "fax_number": "559-261-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUSON",
        "first_name": "PHILIP",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "19857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Ann Corgiat, PHD
• Shirley Ann Corley
• Catherine Cormier-Farrell, RN
• Lawrence Josepj Cormier, LMFT
• Ryan Cornelison, RRT
• Matthew Thomas Cornell
• Cornerstone Caregiving West LLC
• Cornerstone Home Health Inc
• Cornerstone Physical Therapy
• Warren Scott Cornwell, B.S.

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.