Individual provider Active NPI

Madeline Gallegos

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1134829112
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14241765-1206 Issued in UT
Practice address
1438 E Verona Creek Way
Ogden, UT 84405-6757
Phone
(801) 644-5061
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14241765-1206 UT Primary

Addresses

Primary practice location

1438 E Verona Creek Way
Ogden, UT 84405-6757

Mailing address

1438 E Verona Creek Way
Ogden, UT 84405-6757
Phone (801) 644-5061

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgallegos263600@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20251021001543 UT Practitioner - Physician Assistant 5597253716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14241765-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Sep 15, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Sep 15, 2025 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1134829112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 E VERONA CREEK WAY",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056757",
            "telephone_number": "801-644-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 E VERONA CREEK WAY",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056757",
            "telephone_number": "801-644-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14241765-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgallegos263600@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.