Kenneth J Stroub, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS14643 Issued in FL

Practice address

978 Heritage Pass
Davenport, FL 33896-9117

Phone

(407) 635-5956

Fax

(321) 841-6974

NPI assigned

Jul 19, 2006

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

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
• Orlando Health Hospital, Orlando, FL, CCN 100006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kstroub214463@orlandohealth.medalliesdirect.net

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.

• Orlando Physicians Network Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1568693554

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Carespot of Orlando Hsi Urgent Care LLC

  dba CareSpot Urgent Care / CareSpot - Clermont

  • Urgent Care Clinic/Center
  • Orlando, FL
  • NPI 1306367503
  Medicare reassignment
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  NPD (past)
• DH Family Medicine Nashua Inc

  dba Dartmouth Hitchcock Family Medicine Nashua

  • Family Medicine Physician
  • Merrimack, NH
  • NPI 1063616886
  NPD (past)
• Pacific Medical LLC

  dba Dunwoody Urgent Care

  • Emergency Care Clinic/Center
  • Dunwoody, GA
  • NPI 1417011099
  NPD (past)

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

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation
• South Lake Hospital, Inc.

  dba Orlando Health South Lake Hospital

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1447279674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 HERITAGE PASS",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338969117",
            "telephone_number": "407-635-5956",
            "fax_number": "321-841-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 HERITAGE PASS",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338969117",
            "telephone_number": "407-635-5956",
            "fax_number": "321-841-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUB",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "15495",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043788",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074528",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00758898C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Raphael Stephan, DPT
• Ericka E Stephens, APRN, LCSW
• Geoffrey Stewart, M.D.
• Nicole Wilburn Stokes, PA-C, ATC
• Synnamon Alyse Stone, BT
• Tracena Annette Studmire, HOME HEALTH
• William Stupelis
• Alexis Francisco Suarez, APRN
• Prem Srinivas Subramaniyam, MD
• Suma & Durga PA (Advanced Health Specialists)

• Family Medicine Physician in Davenport, FL
• Providers in Davenport, 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 May 18, 2025; 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.