Mackenzie Flynn, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601013318 Issued in MI

Practice address

1535 E State Fair
Highland Park, MI 48203-1257

Phone

(313) 891-2740

Fax

(313) 731-0213

NPI assigned

Sep 29, 2025

Last updated

Sep 29, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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

University of Detroit Mercy School of Dentistry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Livewell Medical Group PLLCGroup PAC ID 0042667529, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Livewell Medical Group PLLC

  • Internal Medicine Physician
  • Hamtramck, MI
  • NPI 1043096688
  Medicare reassignment Care Compare group NPD
• Procare Partners Health PLLC

  • Nephrology Physician
  • Detroit, MI
  • NPI 1528601952
  Medicare reassignment NPD

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1043183650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 E STATE FAIR",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482031257",
            "telephone_number": "313-891-2740",
            "fax_number": "313-731-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 E STATE FAIR",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482031257",
            "telephone_number": "313-891-2740",
            "fax_number": "313-731-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601013318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantinique Evans
• Tamara Meagan Evans
• Tenisha Fields, LLMSW
• First Step Transitional Housing
• Johnella Fitzpatrick
• Andrea Anita Foster
• Monica Frazier
• Frye's New Look Optical
• Frye's New Look Optical
• Jessica Fullenkamp

• Medical Physician Assistant in Highland Park, MI
• Providers in Highland Park, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.