KELLY GREEN MAZUREK M.D.
NPI 1487915203
Internal Medicine - Nephrology in San Diego, CA
About Kelly Green Mazurek M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY GREEN MAZUREK M.D. (NPI 1487915203) is an individual nephrology provider in San Diego, California, licensed in California (A149649) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Farmington, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelly Green Mazurek M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Mazurek's NPI number?
The NPI number for Kelly Mazurek is 1487915203. It was assigned to this individual provider in the NPPES registry on June 7, 2012.
Where is Kelly Mazurek located?
Kelly Mazurek practices at 4510 Viewridge Ave, San Diego, CA 92123. The listed phone number is (866) 413-1582.
What is Kelly Mazurek's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Kelly Mazurek enrolled in Medicare?
Yes. Kelly Mazurek is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Kelly Mazurek was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly Green Mazurek, M.D. · NPI 1487915203
Nephrology physician in San Diego, California. Individual provider, active in the CMS NPPES registry since June 7, 2012.
## Identity
- **NPI:** 1487915203 (Entity type: Individual)
- **Enumerated:** June 7, 2012
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **State license:** A149649 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4510 VIEWRIDGE AVE, San Diego, CA 92123
- **Phone:** (866) 413-1582
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** November 29, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1487915203) · Data from the CMS NPPES public registry.