Individual provider Active NPI

Alexis L Rodriguez, MD

  • Pediatrics Physician
  • Derby, CT
National Provider Identifier
1316264617
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
052111 Issued in CT
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-7252
Fax
(203) 732-1539
NPI assigned
Apr 26, 2010
Last updated
Feb 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 052111 CT Primary

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

67 Maple Ave
Derby, CT 06418-1328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20160223000581 CT Practitioner - Pediatric Medicine 3375848732 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
052111CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
Yale University CurrentSince Jul 1, 2016 Accepting new patients
Middlesex Hospital Pediatrics CurrentSince Feb 1, 2016 Accepting new patients
Middlesex Hospital CurrentSince Feb 1, 2016 Accepting new patients
Griffin Faculty Physicians, Inc. Pediatrics CurrentSince Jan 29, 2026 Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: arodriguez4416@direct.ynhh.org
  • Direct secure messaging: arodriguez14541@middlesexhealthprd.direct-ci.com

Organizations & group practices 5

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": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1316264617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-7252",
            "fax_number": "203-732-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALEXIS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "052111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.