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

Individual provider Physician Assistant · NPI 1326451337

Mr. Jack Mohadeb, PA is a Physician Assistant in Brooklyn, New York. Qualified in 2011, 15 years ago. Practices with Physician Affiliate Group of New York PC, a 1,224-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
15
Licensed in
NY
In the registry since
2014
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

1977 E 15th St
Brooklyn, NY 11229-3307
Phone: (917) 751-6126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 014776-1 (NY)

Record details

NPI number1326451337
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 6, 2014
Last updated in NPPESOctober 24, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Physician Affiliate Group Of New York Pc — 1224 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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