Individual provider Active NPI

Kseniya Tarasova, APRN

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1164245908
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11035785 Issued in FL
Practice address
12201 Research Pkwy Ste 300
Orlando, FL 32826-3265
Phone
(407) 823-2744
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11035785 FL Primary

Addresses

Primary practice location

12201 Research Pkwy Ste 300
Orlando, FL 32826-3265

Mailing address

PO Box 84
Winter Park, FL 32790-0084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250318000517 FL Practitioner - Nurse Practitioner 9739601956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Health, LLCGroup PAC ID 2365440567, 246 clinicians

Practice addresses (Care Compare)

6735 Conroy Rd
Suite 214
Orlando, FL 32835-3571
Phone (407) 395-7040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11035785FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Institute of Orlando, PLLC CurrentSince Feb 10, 2025 Accepting new patients
Gastroenterology Institute of Orlando LLC CurrentSince Feb 10, 2025 Accepting new patients
Gastro Health, LLC CurrentSince Jun 16, 2025 Accepting new patients
Gastro Health LLC Current Accepting new patients
Gastro Health, LLC CurrentSince Jun 16, 2025 Accepting new patients
Galloway Anesthesia Associates LLC Past Accepting new patients

Locations

812 W Oak St
Kissimmee, FL 34741
Phone (407) 201-3686

1111 S Semoran Blvd
Ste A
Orlando, FL 32807
Phone (321) 695-3200

6735 Conroy Rd
Ste 214
Orlando, FL 32835
Phone (407) 395-7040

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kseniya.tarasova@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 6

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1164245908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327900084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 RESEARCH PKWY STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328263265",
            "telephone_number": "407-823-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARASOVA",
        "first_name": "KSENIYA",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11035785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.