Individual provider Active NPI

Roger Kornu, M.D.

  • Rheumatology Physician
  • Tustin, CA
National Provider Identifier
1841386349
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A78140 Issued in CA
Practice address
2552 Walnut Ave Ste 200
Tustin, CA 92780-6983
Phone
(714) 406-4461
Fax
(714) 669-9790
NPI assigned
Oct 4, 2006
Last updated
Jan 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A78140 CA Primary

Addresses

Primary practice location

2552 Walnut Ave Ste 200
Tustin, CA 92780-6983

Mailing address

2552 Walnut Ave Ste 200
Tustin, CA 92780-6983
Phone (714) 406-4461

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000328 CA Practitioner - RheumatologyPractitioner - Internal Medicine 4082643390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Texas Southwestern Medical School at Dallas, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roger Kornu MD PCGroup PAC ID 2365700564, 3 clinicians

Practice addresses (Care Compare)

2552 Walnut Ave
Suite 200
Tustin, CA 92780-6983
Phone (714) 406-4461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78140CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
A78140CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roger Kornu MD PC Rheumatology CurrentSince Apr 7, 2017 Accepting new patients
Robin K Dore MD Inc Rheumatology Past Accepting new patients
Michael I Keller M.D. Inc Specialist Past Accepting new patients

Locations

12791 Newport Ave
Ste 106
Tustin, CA 92780
Phone (714) 406-4461

12791 Newport Ave
Ste 208
Tustin, CA 92780
Phone (714) 505-5500

2552 Walnut Ave
Ste 200
Tustin, CA 92780
Phone (714) 406-4461

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFHFAA

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 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1841386349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 WALNUT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806983",
            "telephone_number": "714-406-4461",
            "fax_number": "714-669-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 WALNUT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806983",
            "telephone_number": "714-406-4461",
            "fax_number": "714-669-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNU",
        "first_name": "ROGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A78140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.