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 Not confirmed with CMS for 17 years — call before visiting
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

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients102
Services billed 226 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Interfaith Professional Physician Services PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 384 clinicians in the practice; 12 are shown here.

Other providers in Brooklyn