Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Pavel Odintsov, APN

Individual provider Adult Health Nurse Practitioner · NPI 1073893178

Mr. Pavel Odintsov, APN is a Nurse Practitioner in New City, New York. Graduated from Rutgers New Jersey Medical School in 2011, 15 years ago. Accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
15
Trained at
Rutgers New Jersey Medical School
Licensed in
NJ, NY
In the registry since
2011
Specialties on file
3
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

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Practice location Address checks out

182 S Main St Ste 106
New City, NY 10956-3318
Phone: (845) 358-4000
Fax: (201) 529-5913
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 306748 (NY)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 306748 (NY)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 26NJ00337800 (NJ)

Record details

NPI number1073893178
Entity typeIndividual (Type 1)
GenderMale
Credentials APN
Sole proprietorNo
NPI enumeratedAugust 19, 2011
Last updated in NPPESAugust 6, 2024
Certification dateAugust 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolRUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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