Active NPI
Maxx Gallegos, M.D.
- Urology Physician
- Boulder, CO
National Provider Identifier
1689966145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- DR0072419
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| C191208 | CA | MD | Urology Physician |
| DR0072419 | CO | MD | Urology Physician |
| MD2017-0027 | NM | MD | Urology Physician |
| U6956 | TX | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brownstein & Crane Surgical Services | Past | 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.
-
- Specialist
- Greenbrae, CA
- NPI 1881058790
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.