Gabriela Walsman Leiva, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9641756-1205 Issued in UT

Practice address

4745 S 3200 W
Taylorsville, UT 84129-2822

Phone

(801) 964-6214

Fax

(877) 497-4661

NPI assigned

May 4, 2011

Last updated

Jan 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 15, 2022 through Mar 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grateful Direct Primary Care PLLC

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1164221974
  NPD (past)

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1477845717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W 7200 S",
            "address_2": "SUITE A",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471043",
            "telephone_number": "801-858-3461",
            "fax_number": "801-955-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 S 3200 W",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841292822",
            "telephone_number": "801-964-6214",
            "fax_number": "877-497-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSMAN LEIVA",
        "first_name": "GABRIELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P9026",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9641756-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Wallace
• Madison Waller
• Walmart Inc.
• Leela Walser
• Makayla Walsh
• Jacob Walster
• Grace Walton
• Jackson Walton
• Jacob Wamsley
• Jieyu Wang

• Family Medicine Physician in Taylorsville, UT
• Providers in Taylorsville, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.