Individual provider Active NPI

Maria Anne Cornelius, M.D.

  • Family Medicine Physician
  • Cortez, CO
National Provider Identifier
1720314461
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8317A Issued in WY
Practice address
1311 N Mildred Rd
Cortez, CO 81321-2231
Phone
(970) 565-6666
NPI assigned
Oct 31, 2009
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8317A WY Primary

Addresses

Primary practice location

1311 N Mildred Rd
Cortez, CO 81321-2231

Mailing address

1311 N Mildred Rd
Cortez, CO 81321-2231
Phone (970) 565-6666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200417001153 TX Practitioner - Family Practice 5395933956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS IHS Phoenix AreaGroup PAC ID 2668649567, 72 clinicians

Practice addresses (Care Compare)

200 W Hospital Dr
860 Whiteriver Indian
Whiteriver, AZ 85941-0860
Phone 92833849113532

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8317AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area CurrentSince Mar 30, 2020 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Mar 30, 2020 Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1256947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1720314461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212231",
            "telephone_number": "970-565-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212231",
            "telephone_number": "970-565-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "MARIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-31",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "8317A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortez, CO

Sources for this page

Verify at the official NPI Registry.