Individual provider Active NPI

Brandon A Gaudiano, PHD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1831359009
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01009 Issued in RI
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

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231000290 RI Practitioner - Clinical Psychologist 9537482393 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS01009RIMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: bgaudiano@kent.cernerdirect.carene.org
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.