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UAF LEGACY HEALTH
NPI 1720702434
Clinic/Center - Multi-Specialty in Salt Lake City, UT

Active since September 27, 2022CLIA 46D1014628 · Waiver
150 S 1000 E, SALT LAKE CITY, UT 84102(801) 487-2323(801) 486-3987 Get Directions Write a Review

NPPES record last updated: July 12, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 12, 2023, Sep 27, 2022 (2 updates tracked since 2022).

About Uaf Legacy Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UAF LEGACY HEALTH (NPI 1720702434) is a healthcare organization registered as a multi-specialty in Salt Lake City, Utah and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through July 10, 2027 and lists Ian Mcmahan, Vp Of Clinical Operations & Technol, as its authorized official.

NPPES Registry Identity

NPI1720702434
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameUTAH AIDS FOUNDATION
Location Address150 S 1000 ESalt Lake City, UT 84102-1443
Mailing Address150 S 1000 ESalt Lake City, UT 84102-1443 · (801) 487-2323 · Fax (801) 486-3987
Phone(801) 487-2323
Fax(801) 486-3987
Organization SubpartNo
Authorized OfficialIan McmahanVp Of Clinical Operations & Technol · (801) 487-2323
Enumeration DateSeptember 27, 2022
Last NPPES UpdateJuly 12, 20232 updates tracked since enumeration
NPPES CertifiedJuly 12, 2023
✔ NPI 1720702434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
150 S 1000 E, Salt Lake City, UT 84102
Open in Google Maps ↗

Other Names 1

Doing Business AsUaf Legacy Health

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Uaf Legacy Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Uaf Legacy Health, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Sally Bowen, FNP, APRN, AAHIVS
Nurse Practitioner
NPI 1285256453
150 S 1000 E STE 200
Salt Lake City, UT 84102
(801) 487-2323
✔ PECOSSame address
Matthew Bryan, M.D.
Internal Medicine
NPI 1720349814
150 S 1000 E
Salt Lake City, UT 84102
(801) 823-1988
✔ PECOSSame address
Brandy Farnsworth, CSW
Clinical Social Worker
NPI 1477442861
150 S 1000 E
Salt Lake City, UT 84102
(801) 823-1988
✔ PECOSSame address
Susan Keeshin, MD
Pediatric Medicine
NPI 1871780676
150 S 1000 E
Salt Lake City, UT 84102
(801) 823-1988
✔ PECOS✔ Accepts MedicareSame address
Ryan Gibbs
Clinical Social Worker
NPI 1649960378
1020 S MAIN ST
Salt Lake City, UT 84101
(801) 539-7000
✔ PECOS6.6 mi
Drew Olsen
Mental Health Counselor
NPI 1972083947
344 E 100 S
Salt Lake City, UT 84111
(801) 322-3222
✔ PECOS6.9 mi
Dallyn Steenerson, LCSW
Clinical Social Worker
NPI 1922760222
1963 S 1200 E APT 501
Salt Lake City, UT 84105
(910) 795-7604
✔ PECOS8.6 mi
Nicole Mihalopoulos, MD
Internal Medicine
NPI 1316026883
4578 S HIGHLAND DR STE 380
Millcreek, UT 84117
(801) 306-3632
✔ PECOS11 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D1014628

Uaf Legacy Health · Salt Lake City, UT
Active · expires Jul 10, 2027
CLIA Number46D1014628
Laboratory TypeCommunity Clinic
Certificate Effective DateJuly 11, 2025
Certificate Expiration DateJuly 10, 2027
Laboratory DirectorMatthew Bryan
Laboratory Phone(801) 823-1988
Laboratory LocationUaf Legacy Health150 S 1000 E, Salt Lake City, UT 84102
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Utah Aids Foundation's NPI number?

The NPI number for Utah Aids Foundation is 1720702434. It was assigned to this organization in the NPPES registry on September 27, 2022. The provider is doing business as Uaf Legacy Health.

Where is Utah Aids Foundation located?

Utah Aids Foundation is located at 150 S 1000 E, Salt Lake City, UT 84102. The listed phone number is (801) 487-2323.

What is Utah Aids Foundation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Utah Aids Foundation enrolled in Medicare?

Yes. Utah Aids Foundation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Utah Aids Foundation?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 5 Medicare specialties reassign their Medicare billing to Utah Aids Foundation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3), Internal Medicine (2) and Mental Health Counselor (1). Of these, 4 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Utah Aids Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D1014628) is associated with this NPI, valid through July 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Utah Aids Foundation accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Utah Aids Foundation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Utah Aids Foundation was last updated on July 12, 2023. 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.