Mallory M Wentworth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4466 W Bristol Rd
Flint, MI 48507-3170

Phone

(810) 733-1200

Fax

(810) 733-0688

NPI assigned

Sep 3, 2025

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

Other names 1

• Ms. Mallory M Macksood Former name

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

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Orthopedic Associates P L CGroup PAC ID 6800888124, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Family Orthopedic Associates P L C

  • Orthopaedic Surgery Physician
  • Flint, MI
  • NPI 1215930490

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Family Orthopedic Associates P L C

  • Physical Therapist
  • Flint, MI
  • NPI 1326436817

  Physician Assistant

  NPD

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1619857448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "MALLORY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MACKSOOD",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Sue Welter, RDN
• Jessica Wendel
• Emily Wendling
• Lisa Kay Wendling, D.D.S., M.S.
• Sally Wenk, RN
• Alan R Wenzlick, PAC
• Emily Rose Wenzlick
• Tracy M Werdehoff, BSW
• Heather Werlinger, FNP-C
• Lisa Werner, RN

• Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.