Kellyann Mazich

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1 Healthy Way
Oceanside, NY 11572-1551

Phone

(516) 632-3900

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kellyann McClenahan Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Nassau Physician Group PCGroup PAC ID 2264707884, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

Medicare enrollment (NPD)

Enrolled

State licenses

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

• South Nassau Physician Group PC

  • Emergency Medicine Physician
  • Oceanside, NY
  • NPI 1922460542
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  Care Compare affiliation

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1649905704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZICH",
        "first_name": "KELLYANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLYANN",
            "last_name": "MCCLENAHAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Mason, PA - C
• Melvin Mathai
• Matthew Nester DPM P.C.
• Grace Pacleb Matute
• Gabrielle Rose Mauro
• Sean Thomas McCabe, PSY.D.
• Colleen Emily McCally, D.O.
• Emily Marie McCann, PA
• Devin McCarthy, PA-C
• Kriss McCarthy, PA

• Physician Assistant in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.