DR. SAMUEL ROY CORNELL (DC, ATC) – Chiropractor, NPI 1255880308

DR. SAMUEL ROY CORNELL (DC, ATC) is a healthcare provider. based in Rancho santa margarita, California. specializing in CHIROPRACTIC. They hold the professional credentials DC, ATC. They hold a License No. DC36279 (CA). The NPI Number for DR. SAMUEL ROY CORNELL (DC, ATC) is 1255880308

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMUEL ROY CORNELL (DC, ATC)
NPI
1255880308
Phone
(949) 338-3880
Address
39 FELDSPAR WAY
Enumeration Date
30 September 2016
Last Update Date
19 February 2022

Doctor Profile

Medical School Name
LOS ANGELES COLLEGE OF CHIROPRACTIC
Secondary Phone
3034249549
Graduation Year
2021 (5 years ago)
PAC ID
7719371244
Group Practice PAC ID
1557366606
Professional Enrollment ID
I20230210001463
Address ID
CO800044031AR12189AVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

3,358 CHIROPRACTIC in CA

Provider Addresses for DR. SAMUEL ROY CORNELL (DC, ATC)

  • 39 FELDSPAR WAY

    RANCHO SANTA MARGARITA, CA 926883518

    Phone: (949) 338-3880

    Type: Mailing

  • 24002 VIA FABRICANTE STE 501

    MISSION VIEJO, CA 926913934

    Phone: (949) 454-8811

    Type: Location

  • 4529, West McLellan Road, Glendale, Maricopa County, Arizona, 85301, United States

    GLENDALE, AZ 853014223

    Phone:

    Type: Mailing

  • 11650, West Whyman Avenue, Del Rio Ranch, Avondale, Maricopa County, Arizona, 85323, United States

    AVONDALE, AZ 853238461

    Phone: (949) 338-3880

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230210001463IChiropracticCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98940Chiropractic manipulative treatment, 1-2 spinal regions5713$0
View full utilization report →

Insurance plans in this area (ZIP 92688)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557366606View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
-CO
C H I R O P R A C T I CCO

Reviews

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Frequently asked questions

Can I verify DR. SAMUEL ROY CORNELL (DC, ATC) with an NPI only?
You can start verification with NPI 1255880308 for DR. SAMUEL ROY CORNELL (DC, ATC), then check state licensing separately.
Can I rely on DR. SAMUEL ROY CORNELL (DC, ATC) being an active provider?
As of the registry snapshot, DR. SAMUEL ROY CORNELL (DC, ATC) is marked active.
What is DR. SAMUEL ROY CORNELL (DC, ATC) best known for clinically?
Directory data describes DR. SAMUEL ROY CORNELL (DC, ATC) with Chiropractor. Clinical services aligned with this taxonomy classification.
Does DR. SAMUEL ROY CORNELL (DC, ATC) list a practice location?
Patients near Rancho Santa Margarita, California may find DR. SAMUEL ROY CORNELL (DC, ATC) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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