Roland Godfrey Ottley, P.A

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

003792 Issued in NY

Practice address

585 Schenectady Ave
Brooklyn, NY 11203-1822

Phone

(718) 604-5421

Fax

(718) 604-5527

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Interfaith Professional Physician Services, P.C.

  • Allergy Physician
  • Brooklyn, NY
  • NPI 1457643991
  Medicare reassignment Care Compare group
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• Kingsbrook Medical Associates PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1770844797
  NPD (past)
• Park Slope Physician Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1013018324
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1346380870
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1356307656
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1487724712
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1639756406

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1154475770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "address_2": "DEPT. OF SURGERY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031809",
            "telephone_number": "718-604-5421",
            "fax_number": "718-604-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-604-5421",
            "fax_number": "718-604-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTLEY",
        "first_name": "ROLAND",
        "middle_name": "GODFREY",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "003792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernard John Ott, LCSW
• Barbara Maria Ottenio, DDS
• Melanie Ottenstein
• Ottey Bone and Joint Medical Associate, PLLC
• Jennifer Ottey
• Caitlin C Otto, PHD
• Marisa Otto, M.S.
• Jessica Otty, RN
• Emmanuel M Otuada, RN
• Amanda Otuya

• Surgical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.