Individual provider Active NPI

Maxx Gallegos, M.D.

  • Urology Physician
  • Boulder, CO
National Provider Identifier
1689966145
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DR0072419 Issued in CO
Practice address
5495 Arapahoe Ave Ste 200
Boulder, CO 80303-1225
Phone
(512) 446-9486
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X U6956 TX
Urology Physician 208800000X C191208 CA
Urology Physician 208800000X MD2017-0027 NM
Urology Physician 208800000X DR0072419 CO Primary

Addresses

Primary practice location

5495 Arapahoe Ave Ste 200
Boulder, CO 80303-1225

Mailing address

5495 Arapahoe Ave Ste 200
Boulder, CO 80303-1225
Phone (303) 381-2909

Other practice location 1

4407 Bee Caves Rd Ste 612
West Lake Hills, TX 78746-5285
Phone (512) 446-9486

Other practice location 2

575 Sir Francis Drake Blvd Ste 1
Greenbrae, CA 94904-2307
Phone (415) 625-3230

Other names 1

  • Max Gallegos Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 8, 2024 through Aug 8, 2026

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C191208CAMDUrology Physician
DR0072419COMDUrology Physician
MD2017-0027NMMDUrology Physician
U6956TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brownstein & Crane Surgical Services PastSince May 25, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1689966145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5495 ARAPAHOE AVE STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031225",
            "telephone_number": "303-381-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 ARAPAHOE AVE STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031225",
            "telephone_number": "512-446-9486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4407 Bee Caves Rd Ste 612",
            "address_purpose": "LOCATION",
            "city": "West Lake Hills",
            "state": "TX",
            "postal_code": "787465285",
            "country_code": "US",
            "telephone_number": "512-446-9486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 Sir Francis Drake Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949042307",
            "country_code": "US",
            "telephone_number": "415-625-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MAXX",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "U6956",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C191208",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NM",
            "license": "MD2017-0027",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "DR0072419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAX",
            "last_name": "GALLEGOS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.