SHELBY MARYANN MODEROW
NPI 1366164535
Physician Assistant - Medical in Hill Afb, UT

Active since September 14, 2022PECOS EnrolledAccepts Medicare Assignment
7321 BALMER ST # 570, HILL AFB, UT 84056(801) 586-2273 Get Directions Write a Review

NPPES record last updated: September 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1366164535
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSHELBY MARYANN MODEROW
Location Address7321 BALMER ST # 570Hill Afb, UT 84056-5012
Mailing Address1425 5th St NFargo, ND 58102-2734 · (701) 371-3519
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 14, 2022
NPPES CertifiedSeptember 14, 2022
NPI 1366164535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
7321 BALMER ST # 570, Hill Afb, UT 84056

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.

PECOS PAC ID4981197076
PECOS Enrollment IDI20251205004214
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Preventive Medicine (Aerospace Medicine)
7321 BALMER ST # 570
HILL AFB, UT 84056
Specialist/Technologist (Athletic Trainer)
7321 BALMER ST # 570
HILL AFB, UT 84056
Dental Hygienist
7321 BALMER ST # 570
HILL AFB, UT 84056
Dental Hygienist
7321 BALMER ST # 570
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 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.