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

Mr. Kenneth Roy Mazer

Individual provider Independent Duty Corpsman · NPI 1558565929

Mr. Kenneth Roy Mazer is a Physician Assistant in Ravenna, Ohio. Graduated from George Washington University School of Medicine in 2013, 13 years ago. Practices with University Hospitals Urgent Care, LLC, a 107-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
13
Trained at
George Washington University School of Medicine
Licensed in
OH
In the registry since
2007
Specialties on file
2

Practice location Address checks out

6847 N Chestnut St
Ravenna, OH 44266-3929
Phone: (330) 493-4443
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Psc 814 Box 19, Fpo, AE 09865 — 011306972079805

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.003940RX (OH)
Independent Duty Corpsman Taxonomy 1710I1002X

Record details

NPI number1558565929
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 12, 2007
Last updated in NPPESSeptember 11, 2024
Certification dateSeptember 11, 2024
Mailing address10930 Clay St, Montville, OH 44064-9702

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice University Hospitals Urgent Care, Llc — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare