EDWARD V KORNUSZKO PSY D PA
NPI 1225748569
Psychologist - Clinical in Deland, FL
About Edward V Kornuszko Psy D Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDWARD V KORNUSZKO PSY D PA (NPI 1225748569) is a healthcare organization registered as a clinical in Deland, Florida and active in the NPI registry since November 2022. The organization lists Edward Kornuszko, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Edward V Kornuszko Psy D Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Edward V Kornuszko Psy D PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Edward V Kornuszko Psy D PA's NPI number?
The NPI number for Edward V Kornuszko Psy D PA is 1225748569. It was assigned to this organization in the NPPES registry on November 28, 2022.
Where is Edward V Kornuszko Psy D PA located?
Edward V Kornuszko Psy D PA is located at 964 Megano Blvd, Deland, FL 32724. The listed phone number is (781) 835-5664.
What is Edward V Kornuszko Psy D PA's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Edward V Kornuszko Psy D PA enrolled in Medicare?
Yes. Edward V Kornuszko Psy D PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Edward V Kornuszko Psy D PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Edward V Kornuszko Psy D PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Edward V Kornuszko Psy D PA was last updated on August 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Edward V Kornuszko Psy D Pa · NPI 1225748569
Clinical organization in Deland, Florida. Organization record, active in the CMS NPPES registry since November 28, 2022.
## Identity
- **NPI:** 1225748569 (Entity type: Organization)
- **Enumerated:** November 28, 2022
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Edward Kornuszko, PRESIDENT
## Practice location
- **Address:** 964 MEGANO BLVD, Deland, FL 32724-6502
- **Phone:** (781) 835-5664
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 21, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1225748569) · Data from the CMS NPPES public registry.