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

Kellyann Mazich

Individual provider Physician Assistant · NPI 1649905704

Kellyann Mazich is a Physician Assistant in Oceanside, New York. Qualified in 2022, 4 years ago. Practices with South Nassau Physician Group PC, an 18-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

1 Healthy Way
Oceanside, NY 11572-1551
Phone: (516) 632-3900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1649905704
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 21, 2022
Last updated in NPPESJuly 6, 2026
Certification dateJuly 6, 2026
Mailing address1 Healthy Way, Oceanside, NY 11572-1551

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice South Nassau Physician Group Pc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Oceanside