KENNETH CORNETTA (MD) – Hospice and Palliative Medicine (Internal Medicine) Physician, NPI 1699731109
Hospice and Palliative Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
101 HOSPICE/PALLIATIVE CARE in IN
Provider Addresses for KENNETH CORNETTA (MD)
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (888) 484-3258
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
IU Health Bloomington Hospital, 601, West 2nd Street, Bloomington, Monroe County, Indiana, 47402, United States
BLOOMINGTON, IN 474032317
Phone: (812) 353-3717
Fax: (812) 353-3713
Type: Location
200, North Shadeland Avenue, Indianapolis, Marion, Indiana, 46219, United States
INDIANAPOLIS, IN 462194959
Phone: (317) 962-3834
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2004-08-23
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 |
|---|---|---|---|---|
| I20040823000077 | I | Hospice/Palliative Care | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46202)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | NC | |
| U R O L O G Y | IN | |
| Diagnostic Radiology, Interventional Radiology | NY | |
| Nurse Practitioner | IN | |
| P A T H O L O G Y | IN | |
| O T O L A R Y N G O L O G Y | IN | |
| E N D O C R I N O L O G Y | IN | |
| Family Practice, Sports Medicine | IN | |
| Gastroenterology, Internal Medicine | IN | |
| Orthopedic Surgery | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.