KOOSHA RAMEZANI MD
NPI 1962965863
Student in an Organized Health Care Education/Training Program in Bronx, NY

Q: What is Koosha Ramezani's NPI number?

The NPI number for Koosha Ramezani is 1962965863. It was assigned to this individual provider in the NPPES registry on April 9, 2019.

Q: What is Koosha Ramezani's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Koosha Ramezani was last updated on March 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since April 09, 2019PECOS Enrolled

111 E 210TH ST, BRONX, NY 10467(718) 920-9168 Get Directions Write a Review

NPPES record last updated: March 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 13, 2026, Apr 9, 2019 (2 updates tracked since 2019).

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About Koosha Ramezani Md NPPES

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

KOOSHA RAMEZANI MD (NPI 1962965863) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1962965863

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKOOSHA RAMEZANICredential: MD

Location Address111 E 210TH STBronx, NY 10467-2401

Mailing Address111 E 210th StBronx, NY 10467-2401

Phone(718) 920-9168

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 9, 2019

Last NPPES UpdateMarch 13, 20262 updates tracked since enumeration

NPPES CertifiedMarch 13, 2026

✔ NPI 1962965863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedOphthalmologyTaxonomy 207W00000X · License 0101288650 (VA)

111 E 210TH ST, Bronx, NY 10467

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Koosha Ramezani Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698244648

PECOS Enrollment IDI20260519002999

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.

Other Providers at the Same Location NPPES 20

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

DR. MADHU SHARMA MD

Pediatrics (Pediatric Cardiology)

111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467

Bronx County (718) 741-2538

DR. AMANDA MCNEAR JACOBS M.D.

Pediatrics (Adolescent Medicine)

111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467

Bronx County (718) 920-2306

HEATHER ROOT MD

Internal Medicine (Infectious Disease)