Kathryn Marie Alfonso, DO
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Provo, UT
NPI 1043744931 · NPPES record last updated Mar 6, 2026
Key facts
- NPI
- 1043744931
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 14009205-1204 (UT)
- Practice address
- 1157 N 300 W Ste 201
Provo, UT 84604-6124 - Phone
- (801) 357-1200
- NPI assigned
- Apr 17, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1157 N 300
Suite 201
Provo, UT 84604-6124
Phone (801) 357-1200
Hospital & facility affiliations
- Intermountain Health Utah Valley Hospital
- Intermountain Health Spanish Fork Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.54 of 100
- Quality
- 38.49
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220802003702 | FL | Practitioner - Physical Medicine and Rehabilitation | 7416205679 | Reassigns benefits to 1 organization |
| I20240716001731 | UT | Practitioner - Physical Medicine and Rehabilitation | 7416205679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Florida Clinical Practice Association Inc | Current |
Accepting new patients | |
| Florida Clinical Practice Association Inc | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1157 N 300 W
Ste 201
Provo, UT 84604
Phone (801) 357-1200
819 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-6600
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2021-02218 | NC | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 14009205-1204 | UT | Yes |
| Physical Medicine & Rehabilitation Physician | 208100000X | 64047 | MN |
Addresses
Primary practice location
1157 N 300 W Ste 201
Provo, UT 84604-6124
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
123 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 257-4730
Other names
- Kathryn Alfonso Mettler
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService | Other | Bluemark LLC / Office Ally |
Other providers in Provo, UT
- Austin James Alder
- Brooke Marie Alderks Guymon
- Gustavo Adolfo Alegria
- Aletheia Counseling
- Robyn Deegan Alexander
- Kassandra Lynn Alger
- All Around Dental Care
- All Around Dental Care, LC
- Kristine Allan
- Allen Psychiatry LLC
All providers in Provo, UT · Physical Medicine & Rehabilitation Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.