CORNAVACA CLINIC
NPI 1487140349
General Practice in Gainesville, GA
About Cornavaca Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CORNAVACA CLINIC (NPI 1487140349) is a healthcare organization registered as a general practice in Gainesville, Georgia and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through November 18, 2026 and lists Spring Cornavaca, Business Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 2
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)
Cornavaca Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Cornavaca Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2157968
Cornavaca Clinic · Gainesville, GAFrequently 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 Calixto J Cornavaca Diaz MD LLC's NPI number?
The NPI number for Calixto J Cornavaca Diaz MD LLC is 1487140349. It was assigned to this organization in the NPPES registry on July 3, 2018. The provider is doing business as Cornavaca Clinic.
Where is Calixto J Cornavaca Diaz MD LLC located?
Calixto J Cornavaca Diaz MD LLC is located at 578 S Enota Dr NE Ste C, Gainesville, GA 30501. The listed phone number is (470) 892-6607.
What is Calixto J Cornavaca Diaz MD LLC's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Calixto J Cornavaca Diaz MD LLC enrolled in Medicare?
Yes. Calixto J Cornavaca Diaz MD LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Calixto J Cornavaca Diaz MD LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Calixto J Cornavaca Diaz MD LLC, in Family Practice and General Practice. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Calixto J Cornavaca Diaz MD LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2157968) is associated with this NPI, valid through November 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Calixto J Cornavaca Diaz MD LLC was last updated on July 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Cornavaca Clinic · NPI 1487140349
General Practice organization in Gainesville, Georgia. Organization record, active in the CMS NPPES registry since July 3, 2018.
## Identity
- **NPI:** 1487140349 (Entity type: Organization)
- **Enumerated:** July 3, 2018
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Legal business name:** Calixto J Cornavaca Diaz Md Llc
- **Organization subpart:** No
- **Authorized official:** Spring Cornavaca, BUSINESS ADMINISTRATOR
## Practice location
- **Address:** 578 S ENOTA DR NE STE C, Gainesville, GA 30501-8947
- **Phone:** (470) 892-6607 · **Fax:** (470) 290-8474
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), General Practice (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 3, 2018
- **Other identifiers:** Medicaid 1326381625 (TN); Medicaid 1417990334 (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487140349) · Data from the CMS NPPES public registry.