Individual provider Active NPI

Alfonso Valdivia, PA-C

  • Physician Assistant
  • Elgin, IL
National Provider Identifier
1740149319
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1550 N Randall Rd
Elgin, IL 60123-7876
Phone
(847) 980-7257
NPI assigned
Jan 20, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 IL Primary

Addresses

Primary practice location

1550 N Randall Rd
Elgin, IL 60123-7876

Mailing address

1550 N Randall Rd
Elgin, IL 60123-7876
Phone (815) 398-9491

Other practice location 1

650 S Randall Rd
Algonquin, IL 60102-5944
Phone (815) 398-9491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260318001745 IL Practitioner - Physician Assistant 9830673870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1550 N Randall Rd
Elgin, IL 60123-7876
Phone (815) 398-9491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Mar 9, 2026 Accepting new patients
Orthomidwest, PLLC CurrentSince Mar 9, 2026 Accepting new patients

Locations

650 S Randall Rd
Algonquin, IL 60102
Phone (779) 771-7000

1550 N Randall Rd
Elgin, IL 60123
Phone (815) 569-6355

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1740149319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237876",
            "telephone_number": "815-398-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237876",
            "telephone_number": "847-980-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 S Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601025944",
            "country_code": "US",
            "telephone_number": "815-398-9491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDIVIA",
        "first_name": "ALFONSO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.