Individual provider Active NPI

Cornelius Bela

  • Adult Health Nurse Practitioner
  • Salem, MA
National Provider Identifier
1962912964
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2263012 Issued in MA
Practice address
5 Gables Cir
Salem, MA 01970-1217
Phone
(781) 267-0360
Fax
(781) 267-0360
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2263012 MA
Adult Health Nurse Practitioner 363LA2200X RN2263012 MA Primary

Addresses

Primary practice location

5 Gables Cir
Salem, MA 01970-1217

Mailing address

5 Gables Cir
Salem, MA 01970-1217
Phone (781) 267-0360

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180123000903 MA Practitioner - Nurse Practitioner 2062771942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eliot Community Human ServicesGroup PAC ID 2062488000, 82 clinicians
Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians

Practice addresses (Care Compare)

173 Chelsea St
Everett, MA 02149-4632
Phone (781) 388-6200

45 Dan Rd
Canton, MA 02021-2852
Phone (781) 867-2050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2263012MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Healthcare LLC CurrentSince Apr 1, 2020 Accepting new patients
Eliot Community Human Services CurrentSince Jun 1, 2022 Accepting new patients
Eliot Community Human Services CurrentSince Jun 1, 2022 Accepting new patients

Locations

95 Commercial St
Braintree, MA 02184
Phone (781) 848-0596

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

173 Chelsea St
Everett, MA 02149
Phone (617) 397-2020

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

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 2

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1962912964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GABLES CIR",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701217",
            "telephone_number": "781-267-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GABLES CIR",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701217",
            "telephone_number": "781-267-0360",
            "fax_number": "781-267-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELA",
        "first_name": "CORNELIUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2263012",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2263012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.