Martha Madhu Cornwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055.0031326 Issued in VT

Practice address

357 Shields Dr
Bennington, VT 05201-9810

Phone

(802) 447-1409

Fax

(802) 442-5199

NPI assigned

Dec 26, 2016

Last updated

Nov 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Madhu Martha Cornwell Khan Former name

Medicare fee-for-service enrollment

Enrolled in VT

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brattleboro Retreat

  • Psychiatric Hospital
  • Brattleboro, VT
  • NPI 1730185232
  Medicare reassignment
• Memory Clinic, Inc.

  • Behavioral Neurology & Neuropsychiatry Physician
  • Bennington, VT
  • NPI 1205359213
  Medicare reassignment
• Southwestern Vermont Medical Center, Inc

  dba SVMC Orthopaedics

  • Orthopaedic Surgery Physician
  • Bennington, VT
  • NPI 1487930632
  NPD (past)
• Primary Care Health Partners - New York LLP

  • Family Medicine Physician
  • Plattsburgh, NY
  • NPI 1003861782
  NPD (past)

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

{
    "created_epoch": "1482710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1710422951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 SHIELDS DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052019810",
            "telephone_number": "802-447-1409",
            "fax_number": "802-442-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 SHIELDS DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052019810",
            "telephone_number": "802-447-1409",
            "fax_number": "802-442-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5957 Main St",
            "address_purpose": "LOCATION",
            "city": "Manchester Center",
            "state": "VT",
            "postal_code": "052558913",
            "country_code": "US",
            "telephone_number": "802-362-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "MARTHA",
        "middle_name": "MADHU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-26",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADHU",
            "last_name": "KHAN",
            "middle_name": "MARTHA CORNWELL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Catherine Collins-Reed, LICSW
• Carley Lynn Colotti, RD, LD
• Carol M Comar Frost, NP
• Robert Condolora
• Landree M Corcoran
• Counseling With Denise, PLLC
• Parker Elizabeth Crandall, OTRL
• Tracie Ann Crawford, FNP
• CSR Corp (Crescent Manor Care Ctr)
• Kingsley Clay Czermerys

• Physician Assistant in Bennington, VT
• Providers in Bennington, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.