SHELBY MARYANN MODEROW
NPI 1366164535
Physician Assistant - Medical in Hill Afb, UT
About Shelby Maryann Moderow NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHELBY MARYANN MODEROW (NPI 1366164535) is an individual medical provider in Hill Afb, Utah and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shelby Maryann Moderow is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Utah Hospitals And Clinics
Acute Care Hospitals · Salt Lake City, UTOther Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HILL AFB, UT 84056
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shelby Moderow's NPI number?
The NPI number for Shelby Moderow is 1366164535. It was assigned to this individual provider in the NPPES registry on September 14, 2022.
Where is Shelby Moderow located?
Shelby Moderow practices at 7321 Balmer St # 570, Hill Afb, UT 84056. The listed phone number is (801) 586-2273.
What is Shelby Moderow's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Shelby Moderow enrolled in Medicare?
Yes. Shelby Moderow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Shelby Moderow affiliated with any hospitals?
According to CMS data, Shelby Moderow is affiliated with University Of Utah Hospitals And Clinics.
When was this NPI record last updated?
The NPPES record for Shelby Moderow was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shelby Maryann Moderow · NPI 1366164535
Medical physician in Hill Afb, Utah. Individual provider, active in the CMS NPPES registry since September 14, 2022.
## Identity
- **NPI:** 1366164535 (Entity type: Individual)
- **Enumerated:** September 14, 2022
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **Sole proprietor:** No
## Practice location
- **Address:** 7321 BALMER ST # 570, Hill Afb, UT 84056-5012
- **Phone:** (801) 586-2273
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** September 21, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1366164535) · Data from the CMS NPPES public registry.