Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Madison Rae Groberg

Individual provider Physician Assistant · NPI 1043837404

Madison Rae Groberg is a Physician Assistant in Logan, Utah. Qualified in 2020, 6 years ago. Practices with Pearl Health Clinic, a 38-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

115 Golf Course Rd Ste E
Logan, UT 84321-5934
Phone: (435) 999-4059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-2019 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1043837404
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 1, 2020
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026
Mailing address115 Golf Course Rd Ste E, Logan, UT 84321-5934

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Pearl Health Clinic — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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