SIMON M CORNELISSEN (MD) – Orthopaedic Surgery Physician, NPI 1699759415
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
947 ORTHOPEDIC SURGERY in MA
Provider Addresses for SIMON M CORNELISSEN (MD)
100 ONeil Blvd
Attleboro, MA 027034250
Phone: (508) 342-1103
Fax: (508) 342-1945
Type: Location
Stoughton, Norfolk County, Massachusetts, 03072, United States
STOUGHTON, MA 020720030
Phone: (781) 344-3535
Fax: (508) 535-0192
Type: Mailing
15 ROCHE BROS WAY
NORTH EASTON, MA 02356
Phone: (781) 344-3535
Fax: (508) 535-0192
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2023-07-13 • Largest payer in this snapshot: Kairos Surgical Inc ($36).
Total Amount
$36
General + Research + Ownership
Payments
1
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kairos Surgical Inc | $36 |
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: 2022-10-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20050923000822 | I | Orthopedic Surgery | MA | TBD |
| I20221018000388 | I | Orthopedic Surgery | RI | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 725 | 438 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 262 | 187 | $0 |
| 73130 | X-ray of hand, minimum of 3 views | 251 | 186 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 225 | 225 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 188 | 131 | $0 |
Insurance plans in this area (ZIP 02703)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| Orthopedic Surgery | MA | |
| Occupational Therapist In Private Practice | MA | |
| Physical Medicine And Rehabilitation | MA | |
| Hand Surgery, Orthopedic Surgery | MA | |
| Physician Assistant | MA | |
| Orthopedic Surgery | MA | |
| - | MA | |
| Anesthesiology, Pain Management | MA | |
| Physician Assistant | MA |
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