DR. JAN ROMAN KORNILOW (M.D.) – Emergency Medicine Physician, NPI 1487653515
Emergency Medicine Physician
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NPPES metrics only — not quality of care.
1,266 EMERGENCY MEDICINE in IN
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Provider Addresses for DR. JAN ROMAN KORNILOW (M.D.)
2401, West University Avenue, Muncie, Delaware County, Indiana, 47303, United States
MUNCIE, IN 473033428
Phone: (260) 969-1950
Type: Location
A-Reliable Glass & Door Corp., 4128, West Belmont Avenue, Hermosa, Chicago, Jefferson Township, Cook County, Illinois, 60641, United States
CHICAGO, IL 606860057
Phone: (260) 969-1950
Fax: (260) 918-2137
Type: Mailing
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $492.
Total Amount is formed as General ($492) + Research ($0) + Ownership ($0) = $492.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Organogenesis Inc. ($280).
Total Amount
$492
General + Research + Ownership
Payments
22
Total payment records
General Amount
$492
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $280 |
| Kerecis Limited | $81 |
| MIMEDX Group, Inc. | $40 |
| TACTILE SYSTEMS TECHNOLOGY INC | $29 |
| Medtronic, Inc. | $28 |
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: 2006-04-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060413000119 | I | Emergency Medicine | IN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 445 | 93 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 106 | 103 | $0 |
| 99183 | Management of oxygen chamber therapy | 84 | 11 | $0 |
| 99291 | Critical care, first 30-74 minutes | 82 | 79 | $0 |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 78 | 20 | $0 |
Insurance plans in this area (ZIP 47303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Geriatric Medicine, Internal Medicine | NJ | |
| Nurse Practitioner | TX | |
| - | IN | |
| - | IN | |
| - | IN | |
| - | IN | |
| Cardiovascular Disease (Cardiology) | IN | |
| - | IN | |
| - | IN |
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