Alex P. Pavidapha, M.D

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

0101273549 Issued in VA

Practice address

1801 Robert Fulton Drive, Suite 510
Reston, VA 20191-5481

Phone

(703) 783-5355

NPI assigned

May 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Interventional Radiology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastrointestinal Specialists LLCGroup PAC ID 5294797957, 79 clinicians

Anderson Clinic LLCGroup PAC ID 2264331263, 75 clinicians

Potomac Urology Center, LLCGroup PAC ID 1557329406, 17 clinicians

Gastroenterology Associates of Northern Virginia, LLCGroup PAC ID 1759371008, 98 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.62 of 100Reported as group

Quality

53.18

Promoting interoperability

99

Improvement activities

40

Cost

76.38

Merit-based Incentive Payment System (MIPS)

Final score

80.52 of 100Reported as group

Quality

56.13

Promoting interoperability

98

Improvement activities

40

Cost

80.61

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAAEAA/Endpoint/EAAEAA
• Direct secure messaging: alex.pavidapha@gastrohealth.eclinicaldirectplus.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.

• Anderson Clinic LLC

  dba Anderson Clinic Inc

  • Orthopaedic Surgery Physician
  • Arlington, VA
  • NPI 1568488799

  DC

  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368

  DC

  Medicare reassignment Care Compare group NPD
• Gastrointestinal Specialists LLC

  • Gastroenterology Physician
  • Richmond, VA
  • NPI 1063516672

  DC

  Medicare reassignment Care Compare group
• Gastrointestinal Specialists LLC

  • Urology Physician
  • Woodbridge, VA
  • NPI 1861588592

  DC

  Medicare reassignment Care Compare group
• Loudoun Medical Group, PC

  dba Urogynecology Center of Northern Virginia

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Reston, VA
  • NPI 1407908817

  DC

  Medicare reassignment NPD
• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  Medicare reassignment NPD
• Loudoun Medical Group, PC

  dba Loudoun Medical Group, PC 'D'

  • Vascular Surgery Physician
  • Reston, VA
  • NPI 1588376321
  NPD
• Anderson Clinic LLC

  dba Anderson Clinic Inc

  • Orthopaedic Surgery Physician
  • Oxon Hill, MD
  • NPI 1205666435
  NPD
• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

{
    "created_epoch": "1431820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1053799585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ROBERT FULTON DRIVE, SUITE 510",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915481",
            "telephone_number": "703-783-5355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19500 Sandridge Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201763690",
            "country_code": "US",
            "telephone_number": "703-783-5355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVIDAPHA",
        "first_name": "ALEX",
        "middle_name": "P.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-17",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101273549",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "287471",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "287471",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101273549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053799585",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017438440001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Pearson & Associates
• Catherine Cairo Patrick
• Gabrielle Parisi Patterson, MS, RD, LDN
• Wanda M Patterson, M.D.
• Victory Paul-Ikhana
• Peak Performance Physical Therapy, PLC
• Jeffrey Peckins, DPT
• Pediatric Physicians of Reston, PC (Reston Town Center Pediatrics)
• Pediatrix Medical Group of the Mid-Atlantic PC
• Pediatrix Medical Group of the Mid-Atlantic PC

• Vascular & Interventional Radiology Physician in Reston, VA
• Providers in Reston, VA by specialty
• Vascular & Interventional Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.