Active NPI
Ramiz Rafailov, PSY.D.
- Psychologist
- Bronx, NY
National Provider Identifier
1194240614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 026301
- Practice address
- 1400 Pelham Pkwy S Ste 146-20
Bronx, NY 10461-1119 - Phone
- (718) 918-6616
- NPI assigned
- Aug 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 026301 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S Ste 146-20
Bronx, NY 10461-1119
Mailing address
1400 Pelham Pkwy S Ste 146-20
Bronx, NY 10461-1119
Phone (718) 918-6616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814003902 | NY | Order and Referring Only - Clinical Psychologist | 9537607080 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026301 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1194240614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S STE 146-20",
"city": "BRONX",
"state": "NY",
"postal_code": "104611119",
"telephone_number": "718-918-6616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S STE 146-20",
"city": "BRONX",
"state": "NY",
"postal_code": "104611119",
"telephone_number": "718-918-6616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFAILOV",
"first_name": "RAMIZ",
"name_prefix": "Mr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-04",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "026301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.