Carl D Gandola, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

45251 Issued in KY

Practice address

1500 James Simpson Jr Way
Suite 201
Covington, KY 41011-0801

Phone

(859) 655-8980

Fax

(859) 655-8981

NPI assigned

Dec 20, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgandola138104@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Internal Medicine

  Medicare reassignment NPD
• Summit Medical Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1376529461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-655-8980",
            "fax_number": "859-655-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 JAMES SIMPSON JR WAY",
            "address_2": "SUITE 201",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410110801",
            "telephone_number": "859-655-8980",
            "fax_number": "859-655-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOLA",
        "first_name": "CARL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP405",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35043698",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "45251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64785306",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401578",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shari Anne Franco-Fisher, LPCCS
• Robert Allan Fried, M.D.
• Karen Frisch, RN
• Jessica Ann Fulton, MD
• Kaeleigh Gale, OTR/L
• Courtney Gardner
• Garrard Convalescent Home SNF
• Maria Caridad Garriga, NBC-HWC
• Garvin Therapeutic, PLLC
• Sarrah Garvin, PCC

• Internal Medicine Physician in Covington, KY
• Providers in Covington, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.