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CHETHAN RAM MUDIYAM MD
NPI 1609361971
Obstetrics & Gynecology in Phoenix, AZ

Active since June 28, 2018PECOS Enrolled
1441 N 12TH ST, PHOENIX, AZ 85006(602) 521-5700(602) 521-5701 Get Directions Write a Review

NPPES record last updated: September 4, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 4, 2019, Jun 28, 2018 (2 updates tracked since 2018).

About Chethan Ram Mudiyam Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHETHAN RAM MUDIYAM MD (NPI 1609361971) is an individual obstetrics & gynecology provider in Phoenix, Arizona, licensed in Arizona (R77674) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and is a graduate of University Of Toledo College Of Medicine (2018).

NPPES Registry Identity

NPI1609361971
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameCHETHAN RAM MUDIYAMCredential: MD
Location Address1441 N 12TH STPhoenix, AZ 85006-2837
Mailing Address1111 E Mcdowell RdPhoenix, AZ 85006-2612 · (602) 839-3827 · Fax (602) 839-2359
Phone(602) 521-5700
Fax(602) 521-5701
Sole ProprietorNo
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 2018
Enumeration DateJune 28, 2018
Last NPPES UpdateSeptember 4, 20192 updates tracked since enumeration
✔ NPI 1609361971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in AZ · R77674
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1441 N 12TH ST, Phoenix, AZ 85006
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chethan Ram Mudiyam Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID446507909
PECOS Enrollment IDI20250722003412
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85006 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LINDSEY RENTERIA NP
Nurse Practitioner
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5900
MISS VAISHALI RAVIKUMAR MD
Student in an Organized Health Care Education/Training Program
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5700
FORREST D GORTER PAC
Physician Assistant
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 747-4577
ASHLEY THAIN PA-C
Physician Assistant
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5700
DR. KATHLEEN LANGFORD CURLEY MD
Obstetrics & Gynecology
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5700
DEANN ANITRA PADILLA FNP-BC
Nurse Practitioner (Family)
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5900
ALICIA MOANA TAASE
Surgery
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-5969
DR. LAWRENCE MICHAEL KASPER M.D.
Internal Medicine (Hematology & Oncology)
1441 N 12TH ST
PHOENIX, AZ 85006
Maricopa County (602) 521-3700

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 Chethan Mudiyam's NPI number?

The NPI number for Chethan Mudiyam is 1609361971. It was assigned to this individual provider in the NPPES registry on June 28, 2018.

Where is Chethan Mudiyam located?

Chethan Mudiyam practices at 1441 N 12th St, Phoenix, AZ 85006. The listed phone number is (602) 521-5700.

What is Chethan Mudiyam's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Chethan Mudiyam enrolled in Medicare?

Yes. Chethan Mudiyam is registered in the Medicare PECOS enrollment system.

What insurance does Chethan Mudiyam accept?

Health plans from Blue Cross and Blue Shield of NC and Oscar Health Plan of North Carolina, Inc list Chethan Mudiyam 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 Chethan Mudiyam was last updated on September 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.