Individual provider Active NPI

Alexandra Gabrielle Kelley, DO

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1689201279
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A20847 Issued in CA
Practice address
1975 4TH St
San Francisco, CA 94143-2351
Phone
(415) 514-4079
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A20847 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1975 4TH St
San Francisco, CA 94143-2351

Mailing address

1975 4TH St
San Francisco, CA 94143-2351

Other practice location 1

10833 Le Conte Ave # 12-311
Los Angeles, CA 90095-2360
Phone (310) 825-6861

Other practice location 2

500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455

Other names 1

  • Dr. Gabrielle Kelley Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626000644 CA Practitioner - Pediatric Medicine 0547686131 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A20847CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Jun 13, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 13, 2025 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco CurrentSince Jun 13, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 13, 2025 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 13, 2025 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: gkelley425813@direct-ucsfmedicalcenter.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1689201279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-514-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave # 12-311",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900952360",
            "country_code": "US",
            "telephone_number": "310-825-6861",
            "fax_number": "310-206-2119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ALEXANDRA GABRIELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A20847",
            "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": [
        {
            "first_name": "GABRIELLE",
            "last_name": "KELLEY",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.