Individual provider Active NPI

Kenneth Cornetta, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bloomington, IN
National Provider Identifier
1699731109
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
01033270A Issued in IN
Practice address
601 W 2ND St
Bloomington, IN 47403-2317
Phone
(812) 353-3717
Fax
(812) 353-3713
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 01033270 IN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 01033270A IN Primary
Hematology (Internal Medicine) Physician 207RH0000X 01033270A IN
Clinical Genetics (M.D.) Physician 207SG0201X 01033270 IN

Addresses

Primary practice location

601 W 2ND St
Bloomington, IN 47403-2317

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 4

IdentifierTypeStateIssuer
000001365313OtherINANTHEM PTAN
100177180MedicaidIN
000000318026OtherINANTHEM PTAN
000000965063OtherINANTHEM PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KCORNETTA@DIRECT.IUHEALTH.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040823000077 IN Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Hematology 1355315722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Hematology, Internal Medicine
Education
Albany Medical College of Union University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01033270INMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Pathology Institute PC Current Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Current Accepting new patients
Major Hospital Past Accepting new patients
Indiana University Psychiatric Associates, Inc. PastSince Jul 17, 2007 Accepting new patients

Locations

7301 Solutions Ctr
Chicago, IL 60677

413 W 1st St
Bloomington, IN 47403
Phone (812) 332-3531

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

975 W Walnut St
Indianapolis, IN 46202
Phone (317) 274-2241

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

Interoperability endpoints

  • Direct secure messaging: kcornett@direct.iuhealth.org
  • Direct secure messaging: kcornetta@direct.iuhealth.org

Organizations & group practices 5

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.

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1699731109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317",
            "telephone_number": "812-353-3717",
            "fax_number": "812-353-3713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNETTA",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "IN",
            "license": "01033270",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IN",
            "license": "01033270A",
            "primary": true
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "IN",
            "license": "01033270A",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "IN",
            "license": "01033270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001365313",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100177180",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000318026",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000965063",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KCORNETTA@DIRECT.IUHEALTH.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.