Individual provider Active NPI

Pavel Kurosh, FNP-BC

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1609505965
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11018085 Issued in FL
Practice address
12280 Lake Underhill Rd
Orlando, FL 32825-5009
Phone
(239) 224-9547
NPI assigned
Jun 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 APRN11018085 FL Primary

Addresses

Primary practice location

12280 Lake Underhill Rd
Orlando, FL 32825-5009

Mailing address

1054 Cass Ave
Woonsocket, RI 02895-4935
Phone (239) 224-9547

Other practice location 1

1054 Cass Ave
Woonsocket, RI 02895-4935
Phone (401) 767-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, RI, NH, MA, ME6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20220914002887 FL Practitioner - Nurse Practitioner 0547645335 Reassigns benefits to 1 organization
I20250630000009 NJ Practitioner - Nurse Practitioner 0547645335 Reassigns benefits to 1 organization
I20250703001671 RI Practitioner - Nurse Practitioner 0547645335 Reassigns benefits to 1 organization
I20250703001794 NH Practitioner - Nurse Practitioner 0547645335
I20250704000107 MA Practitioner - Nurse Practitioner 0547645335 Reassigns benefits to 2 organizations
I20251211001186 ME Practitioner - Nurse Practitioner 0547645335 Reassigns benefits to 1 organization

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
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

12280 Lake Underhill Rd
Orlando, FL 32825-5009
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11018085FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Primary Care PLLC Current Accepting new patients
Minuteclinic Diagnostic of Maine, LLC Family CurrentSince Oct 4, 2025 Accepting new patients
Minuteclinic Diagnostic of Rhode Island, LLC Family CurrentSince Jun 19, 2025 Accepting new patients
Minuteclinic Diagnostic of New Jersey LLC Family CurrentSince Jun 19, 2025 Accepting new patients
Minuteclinic Diagnostic of Massachusetts LLC Family CurrentSince Jun 19, 2025 Accepting new patients
Minuteclinic Diagnostic of New Hampshire, L.L.C. Family CurrentSince Jun 19, 2025 Accepting new patients
Minuteclinic LLC Family CurrentSince Oct 4, 2025 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

12280 Lake Underhill Rd
Orlando, FL 32825
Phone (407) 273-3284

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

270 Grove St
Braintree, MA 02184
Phone (781) 356-0714

311 Newbury St
Danvers, MA 01923
Phone (978) 605-0100

67D Main St
Medway, MA 02053
Phone (508) 533-6771

1025 Central St
Stoughton, MA 02072
Phone 7813416114 ext. 8221

51 Market St
South Portland, ME 04106
Phone (207) 799-2261

4 Hall St
Concord, NH 03301
Phone (603) 224-3189

471 Main St
Chatham, NJ 07928
Phone (973) 635-4636

4 Ryan Rd
Marlboro, NJ 07746
Phone (732) 431-8700

307 Egg Harbor Rd
Sewell, NJ 08080
Phone (856) 589-1177

1054 Cass Ave
Woonsocket, RI 02895
Phone (401) 767-3600

Interoperability endpoints

  • Direct secure messaging: pavel.kurosh.p51@direct.aara1.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1609505965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954935",
            "telephone_number": "239-224-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12280 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255009",
            "telephone_number": "239-224-9547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954935",
            "country_code": "US",
            "telephone_number": "401-767-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUROSH",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11018085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.