DR. ALEXIS V GADDAM MD
NPI 1164275152
Student in an Organized Health Care Education/Training Program in Phoenix, AZ
About Dr. Alexis V Gaddam Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ALEXIS V GADDAM MD (NPI 1164275152) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Alexis V Gaddam Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHOENIX, AZ 85008
PHOENIX, AZ 85008
Frequently 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 Alexis Gaddam's NPI number?
The NPI number for Alexis Gaddam is 1164275152. It was assigned to this individual provider in the NPPES registry on April 9, 2024. The provider is also known as Dr. Alexis V Roth.
Where is Alexis Gaddam located?
Alexis Gaddam practices at 2601 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (602) 344-5011.
What is Alexis Gaddam's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Alexis Gaddam enrolled in Medicare?
Yes. Alexis Gaddam is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Alexis Gaddam was last updated on September 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Dr. Alexis V Gaddam, MD · NPI 1164275152
Student in an Organized Health Care Education/Training Program provider in Phoenix, Arizona. Individual provider, active in the CMS NPPES registry since April 9, 2024.
## Identity
- **NPI:** 1164275152 (Entity type: Individual)
- **Enumerated:** April 9, 2024
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 2601 E ROOSEVELT ST, Phoenix, AZ 85008-4973
- **Phone:** (602) 344-5011
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** September 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164275152) · Data from the CMS NPPES public registry.