Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alex P. Pavidapha, MD

Individual provider Diagnostic Radiology Physician · NPI 1053799585

Alex P. Pavidapha, MD is an Interventional Radiology in Reston, Virginia. Qualified in 2015, 11 years ago. Practices with Gastrointestinal Specialists LLC, a 79-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts and Virginia.

Years since qualifying
11
Licensed in
MA, VA
In the registry since
2015
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1801 Robert Fulton Dr Ste 510
Reston, VA 20191-5481
Phone: (703) 783-5355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 55 Lake Ave N, Worcester, MA 01655-0002 — (508) 334-3850
  • 19500 Sandridge Way Ste 300, Leesburg, VA 20176-3690 — (703) 783-5355

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X · Licence 0101273549 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0101273549 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 287471 (MA)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence 287471 (MA)

Record details

NPI number1053799585
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 17, 2015
Last updated in NPPESJune 3, 2024
Certification dateJune 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL RADIOLOGY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Gastrointestinal Specialists Llc — 79 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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