Individual provider Active NPI

Cornelia Charles, M.D

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1942569876
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME128846 Issued in FL
Practice address
2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone
(561) 292-4949
NPI assigned
May 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015011040 MO
Internal Medicine Physician 207R00000X ME128846 FL Primary

Addresses

Primary practice location

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969

Mailing address

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone (561) 292-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161004000870 FL Practitioner - Internal Medicine 2062700289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bocacare IncGroup PAC ID 3870633753, 196 clinicians

Practice addresses (Care Compare)

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone (561) 737-7733

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015011040MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bocacare Inc Internal Medicine CurrentSince Feb 7, 2022 Accepting new patients
Bocacare Inc Internal Medicine CurrentSince Feb 7, 2022 Accepting new patients

Locations

1001 NW 13th St
Ste 201
Boca Raton, FL 33486
Phone (561) 864-7853

2815 S Seacrest Blvd
Ste Wer
Boynton Beach, FL 33435
Phone (561) 735-6553

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

Interoperability endpoints

  • Direct secure messaging: cornelia.charles.1@26289.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1942569876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969",
            "telephone_number": "561-292-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969",
            "telephone_number": "561-292-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "CORNELIA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-12",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015011040",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME128846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.