Mallory Wyrick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17629 Issued in TX

Practice address

1250 8TH Ave Ste 135
Fort Worth, TX 76104-4156

Phone

(214) 358-2300

Fax

(214) 579-6993

NPI assigned

Jan 31, 2024

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 TX

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dallas Nephrology AssociatesGroup PAC ID 3870403819, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwyrick70219@direct.acumenmd.com
• FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Dallas Nephrology Associates

  • Nephrology Physician
  • Dallas, TX
  • NPI 1861440109
  Medicare reassignment Care Compare group
• Doctors of Internal Medicine PLLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1194895474
  Medicare reassignment
• Dallas Nephrology Associates

  • Ambulatory Surgical Clinic/Center
  • Dallas, TX
  • NPI 1053634030
  NPD

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

• Baylor All Saints Medical Center

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1669472387
  Care Compare affiliation

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1184487407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LBJ FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE STE 135",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044156",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYRICK",
        "first_name": "MALLORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin D Wylie, DO
• Kristin Wylie, MS, CCC-SLP
• Mark W Wylie, M.D.
• Amber Wynn
• Lee A Wynne, WHNP
• Scott R. Wysowski, PA-C
• Pamela Anna Wysuph
• Katy Kourtney Wyszynski, DO, MS
• Xavier Wellness Center LLC
• Ann Xavier

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.