NPIMap

Individual provider Active NPI

Kellie G Alfaro, PA

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1538677489
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55282 Issued in CA
Practice address
50 N Medical Dr
Salt Lake City, UT 84132
Phone
(801) 587-2267
NPI assigned
Jan 12, 2018
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55282 CA Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132

Mailing address

801 N 29TH St
Billings, MT 59101-0905

Other practice location 1

17712 Neff Ranch Rd
Yorba Linda, CA 92886
Phone (714) 801-4264

Other practice location 2

17712 Neff Ranch Rd
Yorba Linda, CA 92886
Phone (714) 801-4264

Other names 1

  • Kellie G Alfaro Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgrenier407978@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT, MT3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180430002195 CA Practitioner - Physician Assistant 6002170990 Reassigns benefits to 1 organization
I20200121002624 UT Practitioner - Physician Assistant 6002170990 Reassigns benefits to 2 organizations
I20220225001155 MT Practitioner - Physician Assistant 6002170990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-2121

801 N 29TH St
Billings, MT 59101-0905
Phone (406) 238-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.05 of 100Reported as group
Quality
59.76
Promoting interoperability
99
Improvement activities
40
Cost
54.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Surgical Services CurrentSince Oct 24, 2025 Accepting new patients
University of Utah Surgical Services Current Accepting new patients
University of Utah Surgical Services CurrentSince Oct 24, 2025 Accepting new patients
Billings Clinic Current Accepting new patients
University of Utah Specialty Services CurrentSince Nov 9, 2019 Accepting new patients
Billings Clinic CurrentSince Jan 3, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 1, 2018 Accepting new patients
Billings Clinic CurrentSince Jan 3, 2022 Accepting new patients
University of Utah Specialty Services CurrentSince Nov 9, 2019 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

12021 Jacaranda Ave
Hesperia, CA 92345
Phone (909) 558-4207

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

801 N 29th St
Billings, MT 59101
Phone (406) 238-2210

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: kalfaro@billingsclinic.cernerdirect.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1538677489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N 29TH ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-587-2267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17712 Neff Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Yorba Linda",
            "state": "CA",
            "postal_code": "92886",
            "country_code": "US",
            "telephone_number": "714-801-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17712 Neff Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Yorba Linda",
            "state": "CA",
            "postal_code": "92886",
            "country_code": "US",
            "telephone_number": "714-801-4264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALFARO",
        "first_name": "KELLIE",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgrenier407978@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "ALFARO",
            "middle_name": "G",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.