Individual provider Active NPI

Koosha Ramezani, MD

  • Student in an Organized Health Care Education/Training Program
  • Bronx, NY
National Provider Identifier
1962965863
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-9168
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101288650 VA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401

Other practice location 1

2234 Cunningham Dr
Hampton, VA 23666-2555
Phone (757) 622-2200

Other practice location 2

241 Corporate Blvd Ste 210
Norfolk, VA 23502-4965
Phone (757) 622-2200

Other practice location 3

2463 Pruden Blvd
Suffolk, VA 23434-4235
Phone (757) 622-2200

Other practice location 4

465 N Great Neck Rd
Virginia Beach, VA 23454-4064
Phone (757) 622-2200

Other practice location 5

2020 General Booth Blvd
Virginia Beach, VA 23454-5875
Phone (757) 622-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260519002999 VA Practitioner - Ophthalmology 5698244648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1013 Sharpsburg Cir
Birmingham, AL 35213-1729

PO Box
Dallas, TX 75320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101288650VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Eye Consultants Inc Ophthalmology PastSince Feb 1, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1962965863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-9168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2234 Cunningham Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236662555",
            "country_code": "US",
            "telephone_number": "757-622-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 Corporate Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235024965",
            "country_code": "US",
            "telephone_number": "757-622-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2463 Pruden Blvd",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234344235",
            "country_code": "US",
            "telephone_number": "757-622-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "465 N Great Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234544064",
            "country_code": "US",
            "telephone_number": "757-622-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 General Booth Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234545875",
            "country_code": "US",
            "telephone_number": "757-622-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMEZANI",
        "first_name": "KOOSHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101288650",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.