Madisen Jo Affleck, PA-C
Individual provider Active NPI Physician Assistant · Ogden, UT
NPI 1083376701 · NPPES record last updated Feb 6, 2026
Key facts
- NPI
- 1083376701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 14219864-1206 (UT)
- Practice address
- 4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277 - Phone
- (801) 378-7450
- NPI assigned
- Oct 11, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
4401 Harrison Blvd
Ogden, UT 84403-3195
700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600
Hospital & facility affiliations
- Intermountain Health McKay-Dee Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250630003690 | UT | Practitioner - Physician Assistant | 5496140485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14219864-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients |
Locations
3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
4403 Harrison Blvd
Ste 2600
Ogden, UT 84403
Phone (801) 378-7450
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14219864-1206 | UT | Yes |
Addresses
Primary practice location
4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.