Individual provider Active NPI

Alyssa Ann Klop, PA-C

  • Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1902792104
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1840 N Jasper Dr Ste 2
Flagstaff, AZ 86001-1634
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Jun 16, 2025
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 NU Primary

Addresses

Primary practice location

1840 N Jasper Dr Ste 2
Flagstaff, AZ 86001-1634

Mailing address

1840 N Jasper Dr Ste 2
Flagstaff, AZ 86001-1634
Phone (866) 974-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260514002245 AZ Practitioner - Physician Assistant 9234608696 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

Practice addresses (Care Compare)

1840 N Jasper Dr
Suite 2
Flagstaff, AZ 86001-1634
Phone (866) 974-2673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1902792104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 N JASPER DR STE 2",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011634",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N JASPER DR STE 2",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011634",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOP",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.