Organization Active NPI

Gandelman Cardiology, PC

  • Cardiovascular Disease Physician
  • Greenwich, CT
National Provider Identifier
1629264353
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
GANDELMAN CARDIOLOGY, PC
Practice address
81 Holly Hill LN FL 3
Greenwich, CT 06830-2945
Phone
(203) 869-5515
Fax
(203) 869-5765
NPI assigned
Sep 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Glenn Gandelman, M.D.NPI 1033117437
Title
President
Phone
(203) 869-5515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

81 Holly Hill LN FL 3
Greenwich, CT 06830-2945

Mailing address

81 Holly Hill LN FL 3
Greenwich, CT 06830-2945
Phone (203) 869-5515

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glenngandelman@gca.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071019000351 CT Part B Supplier - Clinic/Group Practice 1355437484 Receives reassigned benefits from 7 practitioners
Practice locations: Greenwich, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2262550Gandelman Cardiology, PC81 Holly Hill LN 3Rd FLR, Greenwich, CT 06830Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

Locations

181 Clifton St
New Haven, CT 06513
Phone (203) 467-1666

Interoperability endpoints

  • Direct secure messaging: glenngandelman@gca.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1629264353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HOLLY HILL LN FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068302945",
            "telephone_number": "203-869-5515",
            "fax_number": "203-869-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HOLLY HILL LN FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068302945",
            "telephone_number": "203-869-5515",
            "fax_number": "203-869-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANDELMAN CARDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "GANDELMAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-869-5515",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenngandelman@gca.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "81 Holly Hill Ln Fl 3",
            "city": "Greenwich",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068302945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.