Mallory M Radzik, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704309438 Issued in MI

Practice address

17410 Mack Ave # 1147
Grosse Pointe, MI 48230-6228

Phone

(586) 864-2887

NPI assigned

Oct 26, 2022

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Ih Physician Services PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Clinton Township, MI
  • NPI 1881432060
  Medicare reassignment NPD
• Ih Physician Services, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Knoxville, TN
  • NPI 1770469389
  NPD

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1659098036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17410 MACK AVE # 1147",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482306228",
            "telephone_number": "586-864-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17410 MACK AVE # 1147",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482306228",
            "telephone_number": "586-864-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZIK",
        "first_name": "MALLORY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704309438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Lindsay Price, M.D.
• Mariya Priymak, PA-C
• Piotr Z Purzycki, PA-C
• Laura A Pytiak, CRNA
• Radiant Health Resources
• Shruti Ramakrishna, M.D.
• Nicole L. Ramirez, NP-C
• Malek Rammouni
• Robin Ramsay, PHD
• Lenore Ranieri, RN MSN NP C

• Family Nurse Practitioner in Grosse Pointe, MI
• Providers in Grosse Pointe, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.