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EDGAR D CORNEJO PHYSICIAN ASSISTANT
NPI 1912660440
Physician Assistant in Goodyear, AZ

Active since October 21, 2021PECOS Enrolled
14175 W INDIAN SCHOOL RD STE B4-120, GOODYEAR, AZ 85395(956) 222-7774 Get Directions Write a Review

NPPES record last updated: January 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 11, 2022, Oct 21, 2021 (2 updates tracked since 2021).

About Edgar D Cornejo Physician Assistant NPPES

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

EDGAR D CORNEJO PHYSICIAN ASSISTANT (NPI 1912660440) is an individual physician assistant in Goodyear, Arizona, licensed in Puerto Rico (1100-P.A.) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912660440
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameEDGAR D CORNEJOCredential: PHYSICIAN ASSISTANT
Location Address14175 W INDIAN SCHOOL RD STE B4-120Goodyear, AZ 85395-8407
Mailing Address14175 W Indian School Rd Ste B4-120Goodyear, AZ 85395-8407 · (956) 222-7774
Phone(956) 222-7774
Sole ProprietorNo
Enumeration DateOctober 21, 2021
Last NPPES UpdateJanuary 11, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2022
✔ NPI 1912660440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PR · 1100-P.A.
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
14175 W INDIAN SCHOOL RD STE B4-120, Goodyear, AZ 85395
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Other Names 1

Other Name (5)Edgar De Jesus Cornejo Lomeli Physician Assistant

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edgar D Cornejo Physician Assistant 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85395 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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 Edgar Cornejo's NPI number?

The NPI number for Edgar Cornejo is 1912660440. It was assigned to this individual provider in the NPPES registry on October 21, 2021. The provider is also known as Edgar De Jesus Cornejo Lomeli Physician Assistant.

Where is Edgar Cornejo located?

Edgar Cornejo practices at 14175 W Indian School Rd Ste B4-120, Goodyear, AZ 85395. The listed phone number is (956) 222-7774.

What is Edgar Cornejo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Edgar Cornejo enrolled in Medicare?

Yes. Edgar Cornejo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Edgar Cornejo was last updated on January 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.