ALPINE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC
NPI 1013121003
Specialist in Ogden, UT
About Alpine Plastic And Reconstructive Surgery, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALPINE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC (NPI 1013121003) is a healthcare organization registered as a specialist in Ogden, Utah and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through June 30, 2027 and lists Carole T Grobe, Billing Business Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alpine Plastic And Reconstructive Surgery, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Alpine Plastic And Reconstructive Surgery, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 46D1042547
Alpine Plastic & Reconstructive Surgery Center · Ogden, UTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Alpine Plastic And Reconstructive Surgery, LLC's NPI number?
The NPI number for Alpine Plastic And Reconstructive Surgery, LLC is 1013121003. It was assigned to this organization in the NPPES registry on May 9, 2007.
Where is Alpine Plastic And Reconstructive Surgery, LLC located?
Alpine Plastic And Reconstructive Surgery, LLC is located at 5405 S 500 E Suite101, Ogden, UT 84405. The listed phone number is (801) 689-3500.
What is Alpine Plastic And Reconstructive Surgery, LLC's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Alpine Plastic And Reconstructive Surgery, LLC enrolled in Medicare?
Yes. Alpine Plastic And Reconstructive Surgery, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Alpine Plastic And Reconstructive Surgery, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Alpine Plastic And Reconstructive Surgery, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Alpine Plastic And Reconstructive Surgery, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 46D1042547) is associated with this NPI, valid through June 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Alpine Plastic And Reconstructive Surgery, LLC accept?
Health plans from Molina Healthcare list Alpine Plastic And Reconstructive Surgery, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Alpine Plastic And Reconstructive Surgery, LLC was last updated on May 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Alpine Plastic And Reconstructive Surgery, Llc · NPI 1013121003
Specialist organization in Ogden, Utah. Organization record, active in the CMS NPPES registry since May 9, 2007.
## Identity
- **NPI:** 1013121003 (Entity type: Organization)
- **Enumerated:** May 9, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Carole Grobe, BILLING BUSINESS MANAGER
## Practice location
- **Address:** 5405 S 500 E, SUITE101, Ogden, UT 84405-6957
- **Phone:** (801) 689-3500 · **Fax:** (801) 689-3505
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Plastic and Reconstructive Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 30, 2013
- **Other identifiers:** Medicare PIN 000055634 (UT)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1013121003) · Data from the CMS NPPES public registry.