Individual provider Active NPI

Alexandra Fine

  • Physician Assistant
  • Murray, UT
National Provider Identifier
1386984987
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8894812-1206 Issued in UT
Practice address
5121 S Cottonwood St
Murray, UT 84107-5701
Phone
(801) 507-3462
Fax
(801) 507-3458
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8894812-1206 UT Primary
Physician Assistant 363A00000X 085-004849 IL

Addresses

Primary practice location

5121 S Cottonwood St
Murray, UT 84107-5701

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

3451 S 5600 W
Suite F
West Valley City, UT 84120-1301
Phone (801) 957-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150827003264 UT Practitioner - Physician Assistant 2365678190 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Orthopedic Clinic LC 18 clinicians

Practice addresses (Care Compare)

5848 S Fashion Blvd
Suite 110
Salt Lake City, UT 84107-6175
Phone (801) 314-4188

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54989CAMDPediatric Dentist
085-004849ILMDPhysician Assistant
8894812-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Apr 22, 2019 Accepting new patients
Rosenberg Cooley Metcalf LC Orthopaedic Surgery CurrentSince May 16, 2016 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Sep 1, 2015 Accepting new patients
Ihc Health Services, Inc. CurrentSince Apr 22, 2019 Accepting new patients
Physician Group of Utah Inc CurrentSince Nov 1, 2018 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Sep 1, 2015 Accepting new patients

Locations

1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600

900 Round Valley Dr
Ste 100
Park City, UT 84060
Phone (435) 655-6600

5848 S Fashion Blvd
Ste 110
Salt Lake Cty, UT 84107
Phone (801) 314-4188

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3451 S 5600 W
Ste F
West Valley City, UT 84120
Phone (801) 957-0900

Interoperability endpoints

  • Direct secure messaging: alexandra.fine.1@28271.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IJFECD

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1386984987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-3462",
            "fax_number": "801-507-3458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3451 S 5600 W",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841201301",
            "country_code": "US",
            "telephone_number": "801-957-0900",
            "fax_number": "801-966-4384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FINE",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8894812-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.