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

Roland Godfrey Ottley, PA

Individual provider Surgical Physician Assistant · NPI 1154475770

Roland Godfrey Ottley, PA is a Physician Assistant in Brooklyn, New York. Qualified in 1989, 37 years ago. Practices with Interfaith Professional Physician Services PC, a 384-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
37
Licensed in
NY
In the registry since
2007
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

585 Schenectady Ave
Brooklyn, NY 11203-1822
Phone: (718) 604-5421
Fax: (718) 604-5527
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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 003792 (NY)

Record details

NPI number1154475770
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 22, 2007
Last updated in NPPESJune 10, 2009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Interfaith Professional Physician Services Pc — 384 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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