Nicholas D. Poulos, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

ME90981 Issued in FL

Practice address

6535 Nemours Pkwy
Orlando, FL 32827-7884

Phone

(407) 650-7000

Fax

(407) 567-5924

NPI assigned

Feb 14, 2006

Last updated

Sep 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, IL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.poulos.1@13023.direct.athenahealth.com

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467

  Pediatric Surgery

  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1386658615
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Family Medicine

  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Tenet Florida Physician Services, LLC

  • Physical Therapist
  • West Palm Beach, FL
  • NPI 1699111211
  NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD
• University of Florida Jacksonville Physicians Inc

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1588824858

  Pediatric Surgery

  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD
• Perinatal & Pediatric Specialists Medical Group Inc.

  dba Childrens Specialist Medical Group of Sacramento

  • Specialist
  • Sacramento, CA
  • NPI 1114007432
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694822400000",
    "number": "1669446894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277884",
            "telephone_number": "407-650-7000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "NICHOLAS",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME90981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270512500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667777318A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Linn Potts, LCSW
• Alecia Potzler
• Leianne Pouliot, L.C.S.W.
• Kameryn Poullard, MSW
• Margaret K Poulos, MD
• Cherez Pouncey, NURSE PRACTITIONER
• Kamal K. Pourmoghadam, M.D.
• Behdod Poushanchi, M.D.
• Pow Family Enterprise LLC
• Taiya Powe

• Pediatric Surgery Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatric Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.