Alexandra Kristine Kellogg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA65973 Issued in CA

Practice address

6136 Lake Murray Blvd
La Mesa, CA 91942-2502

Phone

(877) 693-6266

NPI assigned

Aug 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1477236727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 SHASTA LN APT 44",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919424410",
            "telephone_number": "619-840-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 LAKE MURRAY BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422502",
            "telephone_number": "877-693-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "ALEXANDRA",
        "middle_name": "KRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65973",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghazia A Kazmi, DDS
• Wilfred S. Kearse Jr., M.D.
• Meesun Keel-Hammer, PHARM.D.
• Kathleen Matthews Keenan
• Thomas Allen Keller, PH.D.
• Kevin M. Kelly Jr.
• Tammy Boyette Kelly, PA-C
• Thomas B Kelly
• Kassandra Jeannette Kelton
• Stephan John Kempiak, M.D,PH.D

• Physician Assistant in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.