1. Home
  2. Directory
  3. California
  4. Gardena
  5. Nurse Practitioner
  6. NPI Profile

QUINCY JADE CORNELL
NPI 1457037558
Nurse Practitioner - Psychiatric/Mental Health in Gardena, CA

Active since June 23, 2023PECOS Enrolled
1225 W 190TH STREET SUITE 280, GARDENA, CA 90248(877) 515-8113(877) 538-2102 Get Directions Write a Review

NPPES record last updated: September 4, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 4, 2023, Jun 23, 2023 (2 updates tracked since 2023).

About Quincy Jade Cornell NPPES

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

QUINCY JADE CORNELL (NPI 1457037558) is an individual psychiatric/mental health provider in Gardena, California, licensed in California (95023914) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Van Nuys.

NPPES Registry Identity

NPI1457037558
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameQUINCY JADE CORNELL
Location Address1225 W 190TH STREET SUITE 280Gardena, CA 90248-2820
Mailing Address663 Cambridge StSan Francisco, CA 94134-1637 · (415) 203-6169
Phone(877) 515-8113
Fax(877) 538-2102
Sole ProprietorYes
Enumeration DateJune 23, 2023
Last NPPES UpdateSeptember 4, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2023
✔ NPI 1457037558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95023914
1225 W 190TH STREET SUITE 280, Gardena, CA 90248
Open in Google Maps ↗

Secondary Practice Location 1

Location 114541 Delano StVan Nuys, CA 91411-2820 · Phone (877) 515-8113

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Quincy Jade Cornell 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 Reassignment

Medicare enrollment records show Quincy Cornell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dadoyan Behavioral Medical Group Inc
23 mi
Psychiatry
5000 VAN NUYS BLVD STE 202
Sherman Oaks, CA 91403
  • Reassigned Medicare billing, California enrollment
  • 15 clinicians in this Medicare group
NPI 1841687878 (818) 461-8911

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90248 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Quincy Cornell's NPI number?

The NPI number for Quincy Cornell is 1457037558. It was assigned to this individual provider in the NPPES registry on June 23, 2023.

Where is Quincy Cornell located?

Quincy Cornell practices at 1225 W 190th Street Suite 280, Gardena, CA 90248. The listed phone number is (877) 515-8113.

What is Quincy Cornell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Quincy Cornell enrolled in Medicare?

Yes. Quincy Cornell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Quincy Cornell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Quincy Cornell reassigns Medicare benefits to Dadoyan Behavioral Medical Group Inc (Sherman Oaks, CA). The 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 Quincy Cornell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Quincy Cornell was last updated on September 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.