Alan Mark Gandolfi, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

149282 Issued in NY

Practice address

240 Meeting House LN
Southampton, NY 11968-5009

Phone

(631) 726-8420

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Meeting House Lane Medical Practice PC

  • Internal Medicine Physician
  • Southampton, NY
  • NPI 1902088495
  Medicare reassignment NPD
• Cardiothoracic Surgical Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
  • NPI 1588738207
  NPD (past)
• East Hampton Urgent Care PLLC

  • Urgent Care Clinic/Center
  • East Hampton, NY
  • NPI 1538322920
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497769541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117760808",
            "telephone_number": "631-979-4400",
            "fax_number": "631-979-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "631-726-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOLFI",
        "first_name": "ALAN",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "149282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly D. Foster, PHARMACIST
• Francis Yoo, D.O., P.C.
• Michael Frenkel
• Stephanie May Frishman, M.S.
• Thelma Barker Gaetano, M.D.
• David Gandolfo III, DO
• Christina Maria Ganeshalingam, D.O.
• Sarah N Gardella, MS RD CDN
• Juan J Gargiulo, MD
• Kendall Nicole Garrett, MD

• Emergency Medicine Physician in Southampton, NY
• Providers in Southampton, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.