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MALLORY ZUPKE PA-C
NPI 1316560196
Physician Assistant in Fairlawn, OH

Active since May 27, 2020Opted out of Medicare · through Apr 1, 2027
3634 W MARKET ST STE 104, FAIRLAWN, OH 44333(558) 829-8315 Get Directions Write a Review

NPPES record last updated: February 12, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Feb 12, 2025, Nov 10, 2020, Sep 29, 2020 and 1 more (4 updates tracked since 2020).

About Mallory Zupke Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY ZUPKE PA-C (NPI 1316560196) is an individual physician assistant in Fairlawn, Ohio and active in the NPI registry since May 2020. She has opted out of Medicare through April 1, 2027.

NPPES Registry Identity

NPI1316560196
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMALLORY ZUPKECredential: PA-C
Location Address3634 W MARKET ST STE 104Fairlawn, OH 44333-4539
Mailing Address3634 W Market St Ste 104Fairlawn, OH 44333-4539 · (558) 829-8315
Phone(558) 829-8315
Sole ProprietorNo
Enumeration DateMay 27, 2020
Last NPPES UpdateFebruary 12, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2025
✔ NPI 1316560196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3634 W MARKET ST STE 104, Fairlawn, OH 44333
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Mallory Zupke Pa-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2025 through April 1, 2027.

Opt-Out Effective DateApril 1, 2025
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services18 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Zupke's NPI number?

The NPI number for Mallory Zupke is 1316560196. It was assigned to this individual provider in the NPPES registry on May 27, 2020.

Where is Mallory Zupke located?

Mallory Zupke practices at 3634 W Market St Ste 104, Fairlawn, OH 44333. The listed phone number is (558) 829-8315.

What is Mallory Zupke's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mallory Zupke enrolled in Medicare?

No. Mallory Zupke has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mallory Zupke was last updated on February 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.