Individual provider Active NPI

Promil Kukreja

  • Anesthesiology Physician
  • Orlando, FL
National Provider Identifier
1619056058
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME166096 Issued in FL
Practice address
62 Columbia St
Orlando, FL 32806-1115
Phone
(407) 514-3668
Fax
(321) 843-2196
NPI assigned
Nov 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 29673 AL
Anesthesiology Physician 207L00000X ME166096 FL Primary

Addresses

Primary practice location

62 Columbia St
Orlando, FL 32806-1115

Mailing address

62 Columbia St
Orlando, FL 32806-1115
Phone (407) 514-3668

Other practice location 1

1717 6th Ave S
Birmingham, AL 35233-1801
Phone (800) 822-8816

Other practice location 2

619 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-3411

Other identifiers 1

IdentifierTypeStateIssuer
122330500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pkukreja@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090924000612 AL Practitioner - Anesthesiology 5698821189 Reassigns benefits to 1 organization
I20240419003617 FL Practitioner - Anesthesiology 5698821189 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29673ALMDAnesthesiology Physician
ME166096FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 17, 2009 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Anesthesiologists of Greater Orlando Inc Anesthesiology Current Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Apr 4, 2024 Accepting new patients
Anesthesiologists of Greater Orlando Inc Anesthesiology CurrentSince Feb 11, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Anesthesiologists of Greater Orlando Inc Anesthesiology CurrentSince Feb 11, 2025 Accepting new patients

Locations

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

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": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1619056058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331801",
            "country_code": "US",
            "telephone_number": "800-822-8816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKREJA",
        "first_name": "PROMIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-05",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "29673",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME166096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122330500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkukreja@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "619 19th St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352331900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.