1. Home
  2. Directory
  3. Florida
  4. Lake Mary
  5. Internal Medicine
  6. NPI Profile

POTHEN C KORUTH MD
NPI 1093768400
Internal Medicine in Lake Mary, FL

Active since May 18, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 10D1024528 · Waiver
758 N SUN DR, ST # 104, LAKE MARY, FL 32746(407) 333-3303(407) 333-3342 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pothen C Koruth Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

POTHEN C KORUTH MD (NPI 1093768400) is an individual internal medicine provider in Lake Mary, Florida, licensed in Florida (ME0072112) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 13, 2028, and is affiliated with Orlando Health.

NPPES Registry Identity

NPI1093768400
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePOTHEN C KORUTHCredential: MD
Location Address758 N SUN DR, ST # 104Lake Mary, FL 32746-2599
Mailing Address758 N Sun Dr, St # 104Lake Mary, FL 32746-2599 · (407) 333-3303 · Fax (407) 333-3342
Phone(407) 333-3303
Fax(407) 333-3342
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateMay 18, 2006
Last NPPES UpdateMarch 16, 2022
NPPES CertifiedMarch 16, 2022
✔ NPI 1093768400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME0072112
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedSpecialistTaxonomy 174400000X · License ME0072112 (FL)
758 N SUN DR, Lake Mary, FL 32746
Open in Google Maps ↗

Other Identifiers 1

Medicaid269423900FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pothen C Koruth Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42276065
PECOS Enrollment IDI20041201001091
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Pothen Koruth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pothen Koruth MD LLC
Same address
Exclusive Provider Organization
758 N SUN DR
Lake Mary, FL 32746
  • Reassigned Medicare billing, Florida enrollment
NPI 1154599132 (407) 333-3303

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1024528

Pothen Koruth MD LLC · Lake Mary, FL
Active · expires Apr 13, 2028
CLIA Number10D1024528
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2026
Certificate Expiration DateApril 13, 2028
Laboratory DirectorPothen C. Koruth MD
Laboratory Phone(407) 333-3303
Laboratory LocationPothen Koruth MD LLC758 N Sun Dr Ste 104, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
382 services166 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
123 services123 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
87 services53 patients
Blood test, clotting time 85610
A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
76 services11 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
54 services20 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
51 services51 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Orlando Health

Acute Care Hospitals · Orlando, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100006
Location52 W Underwood StOrlando, FL 32806 · Orange County
Emergency services Birthing friendly

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100057
Location1000 Waterman WayTavares, FL 32778 · Lake County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32746 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
73%104 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%263 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
61%7,861 patients3/55-star benchmark: 100%
Falls: Risk Assessment
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
100%73 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%240 patients5/55-star benchmark: 100%
Osteoarthritis (OA): Function and Pain Assessment
Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain
100%21 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%1,376 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,376 patients1/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers16 claims27 services$4.63 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$30.46 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims12 services$17.28 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ZIA FATEMI MD
Internal Medicine
758 N SUN DR, SUITE #104
LAKE MARY, FL 32746
Seminole County (407) 333-3303
POTHEN KORUTH MD LLC
Exclusive Provider Organization
758 N SUN DR
LAKE MARY, FL 32746
Seminole County (407) 333-3303
ALESIE MARTEL
Speech-Language Pathologist
758 N SUN DR
LAKE MARY, FL 32746
Seminole County (407) 852-3300
DR. CONRAD B DANCY D.C.
Chiropractor
758 N SUN DR, SUITE 112
LAKE MARY, FL 32746
Seminole County (407) 804-1101
LORYN BOUDOIN
Behavior Technician
758 N SUN DR
LAKE MARY, FL 32746
Seminole County (407) 317-5435
EHTERAM RAISSI-FARD MD
Pediatrics
758 N SUN DR
LAKE MARY, FL 32746
Seminole County (407) 333-2809
ISABEL MARTINEZ
Behavior Technician
758 N SUN DR
LAKE MARY, FL 32746
Seminole County (407) 317-5435
DR. MAGALY GONZALEZ POPPELL D.M.D.
Dentist (General Practice)
758 N SUN DR, SUITE 100
LAKE MARY, FL 32746
Seminole County (407) 804-9901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pothen Koruth's NPI number?

The NPI number for Pothen Koruth is 1093768400. It was assigned to this individual provider in the NPPES registry on May 18, 2006.

Where is Pothen Koruth located?

Pothen Koruth practices at 758 N Sun Dr St # 104, Lake Mary, FL 32746. The listed phone number is (407) 333-3303.

What is Pothen Koruth's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pothen Koruth enrolled in Medicare?

Yes. Pothen Koruth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Pothen Koruth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pothen Koruth reassigns Medicare benefits to Pothen Koruth MD LLC (Lake Mary, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pothen Koruth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Does Pothen Koruth hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1024528) is associated with this NPI, valid through April 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pothen Koruth accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and Oscar Health Maintenance Organization of Florida and 1 other insurer list Pothen Koruth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Pothen Koruth affiliated with any hospitals?

According to CMS data, Pothen Koruth is affiliated with Orlando Health, Adventhealth Orlando and Adventhealth Waterman.

When was this NPI record last updated?

The NPPES record for Pothen Koruth was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.