Madeline Grainger, PA-C, MPAS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12364386-1206 Issued in UT

Practice address

743 East 300 South
Salt Lake City, UT 84102

Phone

(801) 428-3500

Fax

(385) 227-8362

NPI assigned

Oct 6, 2016

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

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wasatch Homeless Health Care IncGroup PAC ID 9032271697, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgrainger169131@direct.med.utah.edu

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.

• Wasatch Homeless Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Salt Lake City, UT
  • NPI 1528128899
  Medicare reassignment Care Compare group
• Odyssey House Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033143706
  Medicare reassignment
• University of Utah

  • Psychiatric Hospital
  • Murray, UT
  • NPI 1538515903
  NPD (past) Authorized official
• Odyssey House Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1407481245
  NPD

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1831649508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 EAST 300 SOUTH",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-428-3500",
            "fax_number": "385-227-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 EAST 300 SOUTH",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-428-3500",
            "fax_number": "385-227-8362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "697 W 4170 S",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841231326",
            "country_code": "US",
            "telephone_number": "801-587-3000",
            "fax_number": "801-281-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAINGER",
        "first_name": "MADELINE",
        "name_prefix": "Ms.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12364386-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan C. Graham, MD
• Taralyn Graham
• Tyler Graham
• Victoira Julia Graham
• Kathryn Grainger, OT
• Mary Jacqueline Gramer Smithe, LCSW
• Benjamin Herrick Granda
• Grandee Village Home Health Care Services LLC
• Ramesh Grandhi, M.D.
• Stephanie Grandjean, MSW

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.
• 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.

Verify at the official NPI Registry.