DR. KELLY M. MAZZARELLA D.O.
NPI 1770841165
Pediatrics in Dallas, TX

Q: What is Kelly Mazzarella's NPI number?

The NPI number for Kelly Mazzarella is 1770841165. It was assigned to this individual provider in the NPPES registry on April 24, 2012. The provider is also known as Dr. Kelly M. Stoneham D.O..

Q: What is Kelly Mazzarella's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Mazzarella was last updated on June 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since April 24, 2012PECOS Enrolled

5323 HARRY HINES BLVD STOP 7200, DALLAS, TX 75390(214) 730-5437 Get Directions Write a Review

NPPES record last updated: June 3, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jun 3, 2020, Apr 25, 2018, Dec 29, 2016 (3 updates tracked since 2016).

On this page

About Dr. Kelly M. Mazzarella D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY M. MAZZARELLA D.O. (NPI 1770841165) is an individual pediatrics provider in Dallas, Texas, licensed in Texas (S1514) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Jbsa Randolph.

NPPES Registry Identity

NPI1770841165

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. KELLY M. MAZZARELLACredential: D.O.

Location Address5323 HARRY HINES BLVD STOP 7200Dallas, TX 75390-7200

Mailing AddressPo Box 845347Dallas, TX 75390-5347 · (214) 730-5437

Phone(214) 730-5437

Sole ProprietorYes

Enumeration DateApril 24, 2012

Last NPPES UpdateJune 3, 20203 updates tracked since enumeration

NPPES CertifiedJune 3, 2020

✔ NPI 1770841165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TX · S1514

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

5323 HARRY HINES BLVD STOP 7200, Dallas, TX 75390

Open in Google Maps ↗

Other Names 1

Other Name (5)Dr. Kelly M. Stoneham D.o.

Secondary Practice Location 1

Location 1221 Third St BLDG 1040, ATTN: 359 MDG/SGHQJBSA Randolph, TX 78150 · Phone (210) 652-8544

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly M. Mazzarella D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75390 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. JOSEPH KASSAB MD, MS

Student in an Organized Health Care Education/Training Program