NPIMap

Individual provider Active NPI

Marco Cornelio, M.D.

  • Family Medicine Physician
  • Sanford, ME
National Provider Identifier
1902125909
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD19692 Issued in ME
Practice address
25A June St Ste 111
Sanford, ME 04073-2642
Phone
(207) 490-7998
NPI assigned
Jun 1, 2010
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19692 ME Primary
Family Medicine Physician 207Q00000X 244361 MA

Addresses

Primary practice location

25A June St Ste 111
Sanford, ME 04073-2642

Mailing address

PO Box 99
Lincoln, ME 04457-0099
Phone (207) 794-6700

Other practice location 1

175 W Broadway
Lincoln, ME 04457-4000
Phone (207) 794-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130930000051 ME Practitioner - Family Practice 3072747310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians

Practice addresses (Care Compare)

114 Bath Rd
Brunswick, ME 04011-2606
Phone (207) 798-4400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244361MAMDFamily Medicine Physician
MD19692MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
Mainehealth CurrentSince Sep 8, 2018 Accepting new patients
Mainehealth CurrentSince Sep 8, 2018 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

61 Barra Rd
Biddeford, ME 04005
Phone (207) 283-1441

114 Bath Rd
Brunswick, ME 04011
Phone (207) 798-4400

2 Livewell Dr
Kennebunk, ME 04043
Phone (207) 467-6900

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

25A June St
Ste 111
Sanford, ME 04073
Phone (207) 324-5968

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marco.cornelio.1@5857.direct.athenahealth.com

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 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1902125909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044570099",
            "telephone_number": "207-794-6700",
            "fax_number": "207-794-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25A JUNE ST STE 111",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732642",
            "telephone_number": "207-490-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "ME",
            "postal_code": "044574000",
            "country_code": "US",
            "telephone_number": "207-794-6700",
            "fax_number": "207-794-6777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELIO",
        "first_name": "MARCO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD19692",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "244361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

Verify at the official NPI Registry.