Active NPI
Brandon A Gaudiano, PHD
- Clinical Psychologist
- Providence, RI
National Provider Identifier
1831359009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS01009
- Practice address
- 345 Blackstone Blvd
Butler Hospital, Psychosocial Research Program
Providence, RI 02906-4800 - Phone
- (401) 455-6457
- NPI assigned
- Jun 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS01009 | RI | Primary |
Addresses
Primary practice location
345 Blackstone Blvd
Butler Hospital, Psychosocial Research Program
Providence, RI 02906-4800
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 738-7015
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bgaudiano@kent.cernerdirect.carene.org | Health Information Exchange (HIE) | |
| Direct Messaging Address | bgaudiano@direct.carene.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01009 | RI | MD | Clinical Psychologist |
Interoperability endpoints
- bgaudiano@kent.cernerdirect.carene.org
- bgaudiano@direct.carene.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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Warwick, RI
- NPI 1184944662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1831359009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-738-7015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"address_2": "BUTLER HOSPITAL, PSYCHOSOCIAL RESEARCH PROGRAM",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDIANO",
"first_name": "BRANDON",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS01009",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bgaudiano@kent.cernerdirect.carene.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "345 Blackstone Blvd",
"address_2": "Butler Hospital, Psychosocial Research Program",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029064800",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bgaudiano@direct.carene.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "345 Blackstone Blvd",
"address_2": "Butler Hospital, Psychosocial Research Program",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029064800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.