DR. ATOOSA KOUROSH MD - NPI 1053401661 - Pediatrics in Southlake, TX

Q: What is Atoosa Kourosh's NPI number?

The NPI number for Atoosa Kourosh is 1053401661. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Q: What is Atoosa Kourosh's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Allergy/Immunology, with taxonomy code 2080P0201X.

Q: Is Atoosa Kourosh enrolled in Medicare?

No. Atoosa Kourosh has opted out of Medicare through February 7, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Atoosa Kourosh was last updated on November 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

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About Dr. Atoosa Kourosh Md NPPES

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

DR. ATOOSA KOUROSH MD (NPI 1053401661) is an individual pediatric allergy/immunology provider in Southlake, Texas, licensed in Washington (MD00044424) and active in the NPI registry since October 2006. She has opted out of Medicare through February 7, 2027 and remains eligible to order and refer and maintains a secondary practice location in Seattle.

NPPES Registry Identity

NPI1053401661

Entity TypeIndividualFemale

Primary Taxonomy2080P0201X

Provider Legal NameDR. ATOOSA KOUROSHCredential: MD

Location Address1170 N CARROLL AVESouthlake, TX 76092-5306

Mailing Address1170 N Carroll AveSouthlake, TX 76092-5306 · (214) 702-6550 · Fax (214) 894-4182

Phone(214) 702-6550

Fax(214) 894-4182

Sole ProprietorNo

Enumeration DateOctober 13, 2006

Last NPPES UpdateNovember 17, 20226 updates tracked since enumeration

NPPES CertifiedNovember 16, 2022

✔ NPI 1053401661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Allergy/ImmunologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0201X

License✔ Licensed in WA · MD00044424

Definition

A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children.

Also ListedAllergy & ImmunologyTaxonomy 207K00000X · License MD00044424 (WA)

Also ListedPediatricsTaxonomy 208000000X · License MD00044424 (WA)

1170 N CARROLL AVE, Southlake, TX 76092

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Secondary Practice Location 1

Location 15600 14th Ave NWSeattle, WA 98107-3723 · Phone (206) 919-0175 · Fax (206) 567-9797

Other Identifiers 1

OtherP01733874WA · Rr Medicare Wvh

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Atoosa Kourosh Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 7, 2023 through February 7, 2027.

Opt-Out Effective DateFebruary 7, 2023

Opt-Out In Effect ThroughFebruary 7, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 5

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

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