Bardia Khosravi, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in New Haven, Connecticut. His current practice location is
20 York St, New Haven, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 688-4242.
Bardia Khosravi is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285474114.
Physician's Profile
Full Name | Bardia Khosravi |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 20 York St, New Haven, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1285474114
- Provider Enumeration Date: 05/29/2024
- Last Update Date: 05/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 8729527411
- Enrollment ID: I20240826003102
Medical Identifiers
Medical identifiers for Bardia Khosravi such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1285474114 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 3016105 (Massachusetts) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bardia Khosravi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bardia Khosravi, MD 20 York St, New Haven, CT 06510-3220 Ph: (203) 688-4242 | Bardia Khosravi, MD 20 York St, New Haven, CT 06510-3220 Ph: (203) 688-4242 |
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