Alex Michael Trey Pelfrey, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1720733439 Issued in KY

Practice address

75 Hail Knob Rd
Somerset, KY 42503-3434

Phone

(606) 678-9617

NPI assigned

Feb 21, 2022

Sex

Male

Sole proprietor

Yes

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

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Cumberland Physician Practices LLCGroup PAC ID 2567510464, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://97465a19-0dc7-4ef3-9aea-f72e472d3305.gastro.prod.fhir.ema-api.com/fhir/r4/
• Direct secure messaging: alex.pelfrey.1@21269.direct.athenahealth.com

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.

• Lake Cumberland Physician Practices, LLC

  dba Lake Cumberland Orthopedics

  • Orthopaedic Surgery Physician
  • Somerset, KY
  • NPI 1811356892
  Medicare reassignment Care Compare group
• Lake Cumberland Physician Practices LLC

  dba Daniel R Yanicko Jr MD

  • Orthopaedic Surgery Physician
  • Somerset, KY
  • NPI 1104261403
  NPD
• Lake Cumberland Physician Practices LLC

  dba Gastroenterology of Lake Cumberland

  • Gastroenterology Physician
  • Somerset, KY
  • NPI 1174091383

  Physician Assistant

  NPD
• Lake Cumberland Surgery Center LP

  dba Lake Cumberland Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Somerset, KY
  • NPI 1720143779
  NPD (past)

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

• Lake Cumberland Regional Hospital LLC

  dba Lake Cumberland Regional Hospital

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1720733439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HAIL KNOB RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033434",
            "telephone_number": "606-678-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HAIL KNOB RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033434",
            "telephone_number": "606-678-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELFREY",
        "first_name": "ALEX",
        "middle_name": "MICHAEL TREY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-21",
        "last_updated": "2023-01-09",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "1720733439",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joel Patton, PHD
• Paige Marie Pauley, LPCC-S, NCC
• Maria A Pavez, MD
• Maegan Ruth Peach, DO
• Laura Elizabeth Pedersen
• Susan Michele Pell, ATC, PA-C
• Sara Beth Pence, APRN, FNP-BC
• Heather Pendery
• Abigail Alisa Perkins
• Alvin Dale Perkins, MD

• Surgical Physician Assistant in Somerset, KY
• Providers in Somerset, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.