KELLY ANN MASH – Family Medicine Physician, NPI 1336984194

KELLY ANN MASH is a healthcare provider. based in Rocky river, Ohio. specializing in NURSE PRACTITIONER. They hold a License No. APRN.CNP.0036816 (OH). The NPI Number for KELLY ANN MASH is 1336984194

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANN MASH
NPI
1336984194
Phone
(216) 644-6621
Address
2781 COUNTRY CLUB BLVD
Enumeration Date
25 June 2024
Last Update Date
23 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4409604000
Graduation Year
2024 (2 years ago)
PAC ID
0941741862
Group Practice PAC ID
0244605608
Professional Enrollment ID
I20240919000319
Address ID
OH440531611LO3700XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for KELLY ANN MASH

  • 2781 COUNTRY CLUB BLVD

    ROCKY RIVER, OH 441162370

    Phone: (216) 644-6621

    Type: Mailing

  • 3700 KOLBE RD

    LORAIN, OH 440531611

    Phone: (216) 644-6621

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240919000319INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244605608View full group profile
NameSpecialtyState
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
Nurse PractitionerOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineMI
Family Practice, Emergency MedicineOH

Reviews

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Frequently asked questions

Can I verify KELLY ANN MASH with an NPI only?
You can start verification with NPI 1336984194 for KELLY ANN MASH, then check state licensing separately.
Does CMS list KELLY ANN MASH as active?
Yes — KELLY ANN MASH is active in the NPI listing used on this page.
What is KELLY ANN MASH's specialty?
The listing groups KELLY ANN MASH with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does KELLY ANN MASH list a practice location?
Patients near Rocky River, Ohio may find KELLY ANN MASH in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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