Active NPI
Guillermo David Alfonso Jr., DO
- Pediatric Radiology Physician
- Cincinnati, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- 34.017009
- Practice address
- 3333 Burnet Ave
Cincinnati, OH 45229-3026 - Phone
- (513) 636-4200
- NPI assigned
- Mar 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Radiology Physician | 2085P0229X | TP522 | KY | |
| Pediatric Radiology Physician | 2085P0229X | 34.017009 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave
Cincinnati, OH 45229-3026
Mailing address
3333 Burnet Ave, ML 5031
Cincinnati, OH 45229-3026
Phone (513) 636-4200
Other practice location 1
800 Rose St
Lexington, KY 40536-3026
Phone (859) 323-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Edward Via Col of Osteo Medicine-Carolinas Campus, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200
Hospital & facility affiliations
- Cincinnati Children'S Hospital Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.017009 | OH | MD | Pediatric Radiology Physician |
| TP522 | KY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Medical Center | Current | Accepting new patients | |
| University of Kentucky | Current | Accepting new patients |
Locations
3341 Solutions Ctr
Chicago, IL 60677
800 Rose St
Lexington, KY 40536
Phone (859) 257-8562
3333 Burnet Ave
#5031
Cincinnati, OH 45229
Phone (513) 636-4251
3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200
3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Cincinnati, OH
- NPI 1609915784
-
- Diagnostic Radiology Physician
- Lexington, KY
- NPI 1770771974
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- Cincinnati, OH
- NPI 1548212988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756166400000",
"number": "1124588561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE, ML 5031",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4200"
}
],
"practiceLocations": [
{
"address_1": "800 Rose St",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405363026",
"country_code": "US",
"telephone_number": "859-323-2222",
"fax_number": "859-323-5090",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALFONSO",
"first_name": "GUILLERMO",
"middle_name": "DAVID",
"name_suffix": "Jr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-21",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "KY",
"license": "TP522",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "OH",
"license": "34.017009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.