1. Home
  2. Directory
  3. North Carolina
  4. Lewisville
  5. Psychiatry Neurology
  6. NPI Profile

DR. CORNELIO RODERICK RUPERTO MD
NPI 1316065204
Psychiatry & Neurology - Child & Adolescent Psychiatry in Lewisville, NC

Active since March 27, 2007PECOS Enrolled
6620 SHALLOWFORD RD, SUITE 200, LEWISVILLE, NC 27023(336) 945-0345(336) 945-0342 Get Directions Write a Review

NPPES record last updated: October 25, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Cornelio Roderick Ruperto Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CORNELIO RODERICK RUPERTO MD (NPI 1316065204) is an individual child & adolescent psychiatry provider in Lewisville, North Carolina, licensed in North Carolina (2006-01732) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316065204
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. CORNELIO RODERICK RUPERTOCredential: MD
Location Address6620 SHALLOWFORD RD, SUITE 200Lewisville, NC 27023-9504
Mailing Address350 Pilot Ridge DrLewisville, NC 27023-8119 · (336) 945-0345 · Fax (336) 945-0342
Phone(336) 945-0345
Fax(336) 945-0342
Sole ProprietorNo
Enumeration DateMarch 27, 2007
Last NPPES UpdateOctober 25, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1316065204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NC · 2006-01732
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 2006-01732 (NC)
6620 SHALLOWFORD RD, Lewisville, NC 27023
Open in Google Maps ↗

Other Identifiers 1

Medicaid5900260NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Cornelio Roderick Ruperto Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Cornelio Ruperto reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Novant Health Medical Group, LLC
Same address
Psychiatry
6620 SHALLOWFORD RD, SUITE 200
Lewisville, NC 27023
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,998 clinicians in this Medicare group
NPI 1811394612 (336) 945-0345
Forsyth Memorial Hospital Inc
2.1 mi
Family Medicine
1225 LEWISVILLE CLEMMONS RD
Lewisville, NC 27023
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,202 clinicians in this Medicare group
NPI 1902864895 (336) 712-0700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER B LOCKLEAR NCC, LPCS, LCAS, CSI
Counselor (Professional)
6620 SHALLOWFORD RD, SUITE 200
LEWISVILLE, NC 27023
Forsyth County (336) 757-0258
LEWISVILLE FAMILY COUNSELING, PLLC
Counselor (Professional)
6620 SHALLOWFORD RD, SUITE 200
LEWISVILLE, NC 27023
Forsyth County (336) 757-0258
NOVANT HEALTH MEDICAL GROUP, LLC
Psychiatry & Neurology (Psychiatry)
6620 SHALLOWFORD RD, SUITE 200
LEWISVILLE, NC 27023
Forsyth County (336) 945-0345

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 Cornelio Ruperto's NPI number?

The NPI number for Cornelio Ruperto is 1316065204. It was assigned to this individual provider in the NPPES registry on March 27, 2007.

Where is Cornelio Ruperto located?

Cornelio Ruperto practices at 6620 Shallowford Rd Suite 200, Lewisville, NC 27023. The listed phone number is (336) 945-0345.

What is Cornelio Ruperto's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Cornelio Ruperto enrolled in Medicare?

Yes. Cornelio Ruperto is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Cornelio Ruperto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cornelio Ruperto reassigns Medicare benefits to 2 organizations: Novant Health Medical Group, LLC (Lewisville, NC) and Forsyth Memorial Hospital Inc (Lewisville, NC). Each 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 Cornelio Ruperto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Cornelio Ruperto accept?

Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare and Oscar Health Plan of North Carolina, Inc list Cornelio Ruperto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Cornelio Ruperto was last updated on October 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.