Brad Michael Gandolfi, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

292312-1 Issued in NY

Practice address

25 5TH Ave Apt 1F
New York, NY 10003-4308

Phone

(212) 287-7211

Fax

(212) 287-7210

NPI assigned

Apr 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NJ, NY3 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 3

Specialty

Plastic and Reconstructive Surgery

Education

Louisiana State University School of Medicine in New Orleans, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Plastic Surgery NJ LLCGroup PAC ID 4183046568, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgandolfi67976@northwell.direct-ci.com
• Direct secure messaging: brad.gandolfi@direct.hobokenumc.md

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.

• Hudson Plastic Surgery NJ LLC

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1942824867

  NJ

  Medicare reassignment Care Compare group Authorized official
• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134159320
  NPD
• Humc Opco LLC

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  NPD

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1003131053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 5TH AVE APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034308",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 5TH AVE APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034308",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 W 58th St Fl 11",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100192515",
            "country_code": "US",
            "telephone_number": "212-355-7980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N Dean St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076312807",
            "country_code": "US",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 5th Ave Ste 1C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214156",
            "country_code": "US",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDOLFI",
        "first_name": "BRAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-02",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA10153500",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "142117",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "292312-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vani Gandhi, M.D.,
• Rachelle Grace Gandica, M.D.
• Neetha Gandikota, MD
• Anaba NMN Gandini, LP
• David Gandler, M.D.
• Lisa Gandolfo, MD
• Samuel E. Gandy, M.D.
• Jaya B Ganesh, M.D.
• Maya Ganeshan
• Bonnie Greer Gang, LCSW

• Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.