Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Walid M Elzomor, PA-C

Individual provider Surgical Physician Assistant · NPI 1255374930

Mr. Walid M Elzomor, PA-C is a Physician Assistant in Brooklyn, New York. Qualified in 2004, 22 years ago. Practices with St Marys General Medical Group PC, a 74-clinician group and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
22
Licensed in
NJ, NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

506 6th St
Brooklyn, NY 11215-3609
Phone: (718) 780-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 25MP00140500 (NJ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 010232 (NY)

Record details

NPI number1255374930
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2006
Last updated in NPPESSeptember 20, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice St Marys General Medical Group Pc — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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