Nicolas Pavouris, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME77322 Issued in FL

Practice address

1200 S. Pinellas Ave # 11
Jsa Tarpon South Primary Care Center
Tarpon Springs, FL 34689-3716

Phone

(727) 942-8900

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Optumcare Florida LLC

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1235245937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH #200",
            "address_2": "JSA HEALTHCARE CORPORATION",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022211",
            "telephone_number": "727-828-2376",
            "fax_number": "727-568-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S. PINELLAS AVE # 11",
            "address_2": "JSA TARPON SOUTH PRIMARY CARE CENTER",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346893716",
            "telephone_number": "727-942-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVOURIS",
        "first_name": "NICOLAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME77322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubrie L Pappas, PHARMD
• Eleni Paris, LMFT
• Dominique Paschal, APRN
• Steven Lee Pashegoba, PA-C
• Chintan Patel, PT, DPT
• Joseph Pawlik, PT
• Taylor Shea Paxton, CAP
• PCM Health Care of Pinellas County Inc
• Peninsula Care and Rehabilitation Center by Harborview LLC
• Peninsula Rehabilitation and Nursing Center LLC

• Family Medicine Physician in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.