NPIMap

Individual provider Active NPI

Chaun Gandolfo, DO

  • Clinical Cardiac Electrophysiology Physician
  • Lansing, MI
National Provider Identifier
1720441884
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
5101025085 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-1000
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 5101025085 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

2799 W Grand Blvd
Henry Ford Hospital
Detroit, MI 48202-2608
Phone (313) 916-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190712002470 MI Practitioner - Internal Medicine 3476847062 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1140 E Michigan Ave
400 Sparrow Cardiovascular Surgeons
Lansing, MI 48912-1806
Phone (517) 364-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jun 12, 2019 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Henry Ford Health System Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Aug 15, 2025 Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Jun 12, 2019 Accepting new patients
Sparrow Eaton Hospital CurrentSince Nov 23, 2025 Accepting new patients
Edward W Sparrow Hospital Association Cardiovascular Disease CurrentSince Aug 15, 2025 Accepting new patients
Sparrow Eaton Hospital CurrentSince Nov 23, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

800 W Lawrence Ave
Charlotte, MI 48813
Phone (517) 541-5800

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#K15
Detroit, MI 48202
Phone (313) 916-1233

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

901 S Oakland St
Ste 101
Saint Johns, MI 48879
Phone (517) 332-4263

301 Williamston Center Rd
Williamston, MI 48895
Phone (517) 253-5125

Interoperability endpoints

  • Direct secure messaging: chaun.gandolfo.1@16555.direct.athenahealth.com
  • Direct secure messaging: cgandolfo377707@direct.hfhs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1720441884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOLFO",
        "first_name": "CHAUN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MI",
            "license": "5101025085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.