Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Marie Mellum, PA

Individual provider Physician Assistant · NPI 1699403543

Mackenzie Marie Mellum, PA is a Physician Assistant in Farmington, Minnesota. Qualified in 2022, 4 years ago. Practices with Allina Health System, a 3,867-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

21260 Chippendale Ave W
Farmington, MN 55024-1427
Phone: (651) 463-7181
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4300 Marketpointe Dr Ste 100, Bloomington, MN 55435-5435 — (952) 835-9880

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MN)

Record details

NPI number1699403543
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 9, 2022
Last updated in NPPESApril 27, 2023
Certification dateApril 27, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare