Courtney Kornichuk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA7149 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-6000

NPI assigned

Jul 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbrown76149@direct.bostonchildrens.org

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.

• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Surgery Physician
  • Boston, MA
  • NPI 1720037385
  Medicare reassignment NPD
• Children'S Orthopaedic Surgery Foundation, Inc.

  • Pediatric Orthopaedic Surgery Physician
  • Boston, MA
  • NPI 1548344393
  Medicare reassignment
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1043250616
  NPD (past)

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1962056846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNICHUK",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ari Kornbluth, M.D.
• Sergio Korndorfer
• Patryk Kornecki, PHARM.D
• Caleb Bosler Korngold, M.D.
• Phyllis J. Kornguth, MD, PHD
• Ellen M Kornmehl, MD
• Robert R Korom, MD
• Alicia Korona
• Walter Joseph Koroshetz, MD
• Susan A Korrick, M.D.

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.