Pavel Odintsov, APN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

306748 Issued in NY

Practice address

182 S Main St Ste 106
New City, NY 10956-3318

Phone

(845) 358-4000

Fax

(201) 529-5913

NPI assigned

Aug 19, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Rutgers New Jersey Medical School, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Union Square Medical Imaging and Mammography PC

  • Mammography Clinic/Center
  • New York, NY
  • NPI 1912037102
  Medicare reassignment NPD
• Vail Healthcare Medical PLLC

  dba Multi Medic Physicians Services

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1487051207
  Medicare reassignment NPD
• Pavel Odintsov NP in Adult Health PLLC

  • Adult Health Nurse Practitioner
  • New City, NY
  • NPI 1851121610
  NPD Authorized official
• Serenity Psychiatry and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, NY
  • NPI 1932928256
  NPD Authorized official
• Metropolitan Medical Diagnostics, PC

  • Neurology Physician
  • New York, NY
  • NPI 1922517598
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1073893178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "3RD FL",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3906",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 S MAIN ST STE 106",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563318",
            "telephone_number": "845-358-4000",
            "fax_number": "201-529-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODINTSOV",
        "first_name": "PAVEL",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306748",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00337800",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "306748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obs-GYN of Rockland PC
• Ocean NP in Family Health PLLC
• Wanda Luz Octaviano, LMSW
• Marie Michele S Ocvil Domingue
• Fadette Ocvil
• Charles Odowd, MD
• Adelola Aramide Odunlade
• Octavia Oestricher-Nieves, SLP-CF / TSSLD
• Ebere Ogbonna
• Chong K Oh, MD

• Primary Care Nurse Practitioner in New City, NY
• Providers in New City, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.