Individual provider Active NPI

Gonzalo Pandolfi, MD

  • Gastroenterology Physician
  • Yakima, WA
National Provider Identifier
1821010760
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036105332 Issued in IL
Practice address
3909 Creekside Loop
Suite 130
Yakima, WA 98902-4880
Phone
(509) 248-6616
Fax
(509) 248-4983
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036105332 IL Primary

Addresses

Primary practice location

3909 Creekside Loop
Suite 130
Yakima, WA 98902-4880

Mailing address

1243 Rickert Dr
Naperville, IL 60540-0954
Phone (509) 248-7849

Other practice location 1

315 W Carpenter St
Springfield, IL 62702-4901
Phone (217) 545-8000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120410000728 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 4587605308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Gastroenterology LTDGroup PAC ID 8628047735, 22 clinicians

Practice addresses (Care Compare)

1243 Rickert Dr
Naperville, IL 60540-0954
Phone 6305276450150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.11 of 100Reported as group
Quality
92.94
Promoting interoperability
100
Improvement activities
40
Cost
67.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy253
Upper gastrointestinal (GI) endoscopy for acid reflux581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Gastroenterology LTD CurrentSince Apr 1, 2012 Accepting new patients

Locations

39273 Treasury Ctr
Chicago, IL 60694

1243 Rickert Dr
Naperville, IL 60540
Phone (630) 303-5650

Interoperability endpoints

  • Direct secure messaging: gpandolfi16815@direct.edward.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1821010760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 RICKERT DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400954",
            "telephone_number": "509-248-7849",
            "fax_number": "509-249-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 CREEKSIDE LOOP",
            "address_2": "SUITE 130",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024880",
            "telephone_number": "509-248-6616",
            "fax_number": "509-248-4983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Carpenter St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024901",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDOLFI",
        "first_name": "GONZALO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036105332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.