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MRS. MALLORY M WENTWORTH PA-C
NPI 1619857448
Physician Assistant in Flint, MI

Active since September 03, 2025PECOS EnrolledAccepts Medicare Assignment
4466 W BRISTOL RD, FLINT, MI 48507(810) 733-1200(810) 733-0688 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 16, 2026, Nov 26, 2025, Sep 3, 2025 (3 updates tracked since 2025).

About Mrs. Mallory M Wentworth Pa-c NPPES

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

MRS. MALLORY M WENTWORTH PA-C (NPI 1619857448) is an individual physician assistant in Flint, Michigan and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1619857448
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. MALLORY M WENTWORTHCredential: PA-C
Location Address4466 W BRISTOL RDFlint, MI 48507-3170
Mailing Address4466 W Bristol RdFlint, MI 48507-3170 · (810) 733-1200 · Fax (810) 733-0688
Phone(810) 733-1200
Fax(810) 733-0688
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 3, 2025
Last NPPES UpdateJanuary 16, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
✔ NPI 1619857448 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.
4466 W BRISTOL RD, Flint, MI 48507
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Other Names 1

Former Name (1)Ms. Mallory M Macksood Pa-c

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Mallory M Wentworth Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961909122
PECOS Enrollment IDI20251007000287
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48507 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID AARON DOUBBLESTEIN PT
Physical Therapist
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 285-8523
BEVERLY ANNE HEBELER PT
Physical Therapist
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 733-1200
SEANN ELISE WILLSON MD
Orthopaedic Surgery
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 733-1200
DAVID FERNANDEZ MD PC
Orthopaedic Surgery
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 733-1200
LIFESTYLE ENDEAVORS, LLC
Dietitian, Registered
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 908-5433
MONA LEE GOATLEY PT
Physical Therapist
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 285-8523
COREY BROWN PA-C
Physician Assistant
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 733-1200
MEGHAN ELIDA BROOKS MOTRL
Occupational Therapist
4466 W BRISTOL RD
FLINT, MI 48507
Genesee County (810) 342-2029

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 Wentworth's NPI number?

The NPI number for Mallory Wentworth is 1619857448. It was assigned to this individual provider in the NPPES registry on September 3, 2025. The provider is also known as Ms. Mallory M Macksood Pa-C.

Where is Mallory Wentworth located?

Mallory Wentworth practices at 4466 W Bristol Rd, Flint, MI 48507. The listed phone number is (810) 733-1200.

What is Mallory Wentworth's specialty?

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

Is Mallory Wentworth enrolled in Medicare?

Yes. Mallory Wentworth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mallory Wentworth was last updated on January 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.