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

Shelby Maryann Moderow

Individual provider Medical Physician Assistant · NPI 1366164535

Shelby Maryann Moderow is a Physician Assistant in Hill AFB, Utah. Qualified in 2022, 4 years ago. Practices with University of Utah Behavioral Health Services, a 188-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022

Practice location Address checks out

7321 Balmer St # 570
Hill AFB, UT 84056-5012
Phone: (801) 586-2273
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1366164535
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 14, 2022
Last updated in NPPESSeptember 14, 2022
Certification dateSeptember 14, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice University Of Utah Behavioral Health Services — 188 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hill AFB