Active NPI
Rodolfo G Madlang, MD
- Anesthesiology Physician
- Ogden, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 82-169053-1205
- Practice address
- 4401 Harrison Boulevard
McKay Dee Hospital
Ogden, UT 84403 - Phone
- (801) 507-5248
- Fax
- (801) 733-5618
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 82-169053-1205 | UT | Primary |
Addresses
Primary practice location
4401 Harrison Boulevard
McKay Dee Hospital
Ogden, UT 84403
Mailing address
3340 North Center St #800
Lehi, UT 84043-7406
Phone (801) 990-1911
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1502954 | Other | UT | UMWA |
| 2090168 | Other | UT | UNITED HEALTHCARE |
| 804070100 | Medicaid | ID | |
| 870545614MA1 | Other | UT | EDUCATORS MUTUAL |
| 100501221 | Medicaid | NV | |
| 110961800 | Medicaid | WY | |
| PRA04118 | Other | UT | MOLINA |
| QM0000075886 | Other | UT | ALTIUS |
| 107005082102 | Other | UT | IHC |
| 820953 | Medicaid | AZ | |
| 36507 | Other | UT | DESERET MUTUAL |
| 37803 | Other | UT | PEHP |
| 53253 | Other | UT | HEALTHY U |
| 8597445 | Other | UT | WORKERS COMP |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82-169053-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain West Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
Locations
3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788
10150 S Centennial Pkwy
Ste 230
Sandy, UT 84070
Phone (425) 284-1545
150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056
4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800
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.
-
- Anesthesiology Physician
- Lehi, UT
- NPI 1558391763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1710071139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 NORTH CENTER ST #800",
"city": "LEHI",
"state": "UT",
"postal_code": "840437406",
"telephone_number": "801-990-1911",
"fax_number": "801-990-1912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 HARRISON BOULEVARD",
"address_2": "MCKAY DEE HOSPITAL",
"city": "OGDEN",
"state": "UT",
"postal_code": "84403",
"telephone_number": "801-507-5248",
"fax_number": "801-733-5618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADLANG",
"first_name": "RODOLFO",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "82-169053-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1502954",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2090168",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "804070100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870545614MA1",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100501221",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110961800",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PRA04118",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000075886",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107005082102",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "820953",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "36507",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "37803",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "53253",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "8597445",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.