Alexandra Grosvenor Eller, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5792769-1205 Issued in UT

Practice address

30 N 1900 E # 2B-200
Salt Lake City, UT 84132-0002

Phone

(801) 581-7092

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Specialty Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1043614811
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Sleep Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1265727275
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Fillmore, UT
  • NPI 1851338495
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah Adult Services

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
  • NPI 1477957272
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Specialty Services

  • Physical Medicine & Rehabilitation Physician
  • Salt Lake City, UT
  • NPI 1629472311
  NPD
• University of Utah Specialty Services

  • Maternal & Fetal Medicine Physician
  • Elko, NV
  • NPI 1316324973
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1922188838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58859",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841580859",
            "telephone_number": "801-585-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 2B-200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "ALEXANDRA",
        "middle_name": "GROSVENOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "5792769-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6078",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeller49587@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": []
}

• Kelsey Elizondo, LCSW
• Ellas LLC
• Jennifer Elledge
• Madeline Elledge
• Kristi Ellefsen, COTA
• Charles D Eller, MD
• Rachel J Ellingson, LCSW
• Ashley Lee Elliott
• Brittney N Elliott
• Charles Gregory Elliott

• Obstetrics & Gynecology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Obstetrics & Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.