ELLISA BRIANNE CORNELIUS (APRN) – Nurse Practitioner, NPI 1245118686

ELLISA BRIANNE CORNELIUS (APRN) is a healthcare provider. based in Plant city, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN11041237 (FL). The NPI Number for ELLISA BRIANNE CORNELIUS (APRN) is 1245118686

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ELLISA BRIANNE CORNELIUS (APRN)
NPI
1245118686
Phone
(813) 629-9060
Address
3607 MEDULLA RD
Enumeration Date
25 August 2025
Last Update Date
7 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7275232460
Graduation Year
2025 (1 year ago)
PAC ID
2062991557
Group Practice PAC ID
8527368877
Professional Enrollment ID
I20260204004544
Address ID
FL337822909PI6770XNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for ELLISA BRIANNE CORNELIUS (APRN)

  • 3607 MEDULLA RD

    PLANT CITY, FL 335664515

    Phone: (813) 629-9060

    Type: Mailing

  • 331 S FLORIDA AVE STE 201

    LAKELAND, FL 338014626

    Phone: (863) 329-2750

    Type: Location

  • 3607 Medulla Rd

    Plant City, FL 335664515

    Phone: (813) 629-9060

    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: 2026-02-04

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
I20260204004544INurse PractitionerFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33566)

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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: 8527368877View full group profile

Reviews

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Frequently asked questions

How do payers reference ELLISA BRIANNE CORNELIUS (APRN)?
For ELLISA BRIANNE CORNELIUS (APRN), use NPI 1245118686 as the unique 10-digit identifier.
Would ELLISA BRIANNE CORNELIUS (APRN) appear as active to a payer?
You can treat ELLISA BRIANNE CORNELIUS (APRN) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with ELLISA BRIANNE CORNELIUS (APRN)?
ELLISA BRIANNE CORNELIUS (APRN)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Florida is ELLISA BRIANNE CORNELIUS (APRN) registered?
Use Plant City, Florida as the headline location for ELLISA BRIANNE CORNELIUS (APRN) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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