Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mohammad O Azam, PA

Individual provider Medical Physician Assistant · NPI 1669626024

Mohammad O Azam, PA is a Physician Assistant in Mineola, New York. Qualified in 2008, 18 years ago. Practices with New York University, a 5,884-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

120 Mineola Blvd Ste 330
Mineola, NY 11501-4077
Phone: (516) 663-8850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10 E Merrick Rd, Valley Stream, NY 11580-5800 — (516) 256-2017

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 012399 (NY)

Record details

NPI number1669626024
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 12, 2008
Last updated in NPPESAugust 9, 2022
Certification dateAugust 9, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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