Individual provider Active NPI

Matthew Gerald Cornu, MS

  • Marriage & Family Therapist
  • Lexington, KY
National Provider Identifier
1922639129
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
287652 Issued in KY
Practice address
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone
(859) 253-1686
NPI assigned
Jan 28, 2020
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 287652 KY Primary

Addresses

Primary practice location

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Mailing address

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone (859) 253-1686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730002149 KY Practitioner - Marriage and Family Therapist 5092252858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Vista of the Bluegrass IncGroup PAC ID 6608773619, 55 clinicians

Practice addresses (Care Compare)

1351 Newtown Pike
BLDG 5
Lexington, KY 40511-1282
Phone (859) 494-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
New Vista of the Bluegrass Inc CurrentSince May 16, 2024 Accepting new patients
New Vista of the Bluegrass CurrentSince May 16, 2024 Accepting new patients
New Vista of the Bluegrass Inc Current Accepting new patients

Locations

1351 Newtown Pike
Bldg 1
Lexington, KY 40511
Phone (858) 253-1686

1351 Newtown Pike
Bldg 5
Lexington, KY 40511
Phone (859) 233-0444

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.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1922639129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNU",
        "first_name": "MATTHEW",
        "middle_name": "GERALD",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "287652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.