Individual provider Active NPI

Mallory Kislow

  • Audiologist
  • East Meadow, NY
National Provider Identifier
1215343298
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
57002525 Issued in NY
Practice address
30 Merrick Ave Ste 109
East Meadow, NY 11554-1580
Phone
(516) 416-4588
NPI assigned
Jul 10, 2014
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 57002525 NY Primary

Addresses

Primary practice location

30 Merrick Ave Ste 109
East Meadow, NY 11554-1580

Mailing address

30 Merrick Ave Ste 109
East Meadow, NY 11554-1580
Phone (516) 416-4588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421000680 NY Practitioner - Qualified Audiologist 0446578561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Ahc Ilh LTDGroup PAC ID 9638578776, 5 clinicians

Practice addresses (Care Compare)

191 Main St
Port Washington, NY 11050-3242
Phone (516) 883-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57002525NYMDAudiologist
002525NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahc Ilh LTD CurrentSince Aug 31, 2022 Accepting new patients
Ahc Ilh LTD Audiologist Past Accepting new patients

Locations

30 Merrick Ave
Ste 109
East Meadow, NY 11554
Phone (516) 260-5950

30 E 60th St
Ste 605
New York, NY 10022
Phone (212) 433-2723

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1215343298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MERRICK AVE STE 109",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541580",
            "telephone_number": "516-416-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MERRICK AVE STE 109",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541580",
            "telephone_number": "516-416-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLOW",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "57002525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.