Ayelet Mottahedeh, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

015376 Issued in NY

Practice address

623 Stewart Ave Ste 106
Garden City, NY 11530-4771

Phone

(516) 650-3355

Fax

(866) 706-0812

NPI assigned

Mar 28, 2012

Last updated

Feb 24, 2025By the provider in NPPES

Sex

Female

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chris Demetriou MD PCGroup PAC ID 4284816927, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• Chris Demetriou MD PC

  • Gastroenterology Physician
  • Garden City, NY
  • NPI 1386954279
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1154697753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 STEWART AVE STE 106",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304771",
            "telephone_number": "516-650-3355",
            "fax_number": "866-706-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 STEWART AVE STE 106",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304771",
            "telephone_number": "516-650-3355",
            "fax_number": "866-706-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Old Country Rd Ste 520",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115014298",
            "country_code": "US",
            "telephone_number": "516-739-7482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Marcus Ave Ste E130",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110421051",
            "country_code": "US",
            "telephone_number": "516-437-6900",
            "fax_number": "516-437-6904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Northern Blvd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Greenvale",
            "state": "NY",
            "postal_code": "115481220",
            "country_code": "US",
            "telephone_number": "516-590-3700",
            "fax_number": "516-217-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 Franklin Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115301600",
            "country_code": "US",
            "telephone_number": "516-650-3355",
            "fax_number": "866-706-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTTAHEDEH",
        "first_name": "AYELET",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Steven Morris, MD
• Maria G Morrone, D.C.
• Nicole M Mosca, M.A. CCC-SLP TSSLD
• Gianni Moshero, P.A.
• Robert William Motta, PH.D.
• Mount Sinai School of Medicine
• Kalliopi E Moutzouroulias, M.S., CCC-SLP/TSSLD
• Move Play Say, Speech Therapy PLLC
• Movement Initiative Physical and Occupational Therapy PLLC
• Moving in New Directions Psychiatric NP PLLC

• Physician Assistant in Garden City, NY
• Providers in Garden City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.