Hudson Plastic Surgery NJ LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

HUDSON PLASTIC SURGERY NJ LLC

Practice address

25 5TH Ave
Suite 1F
New York, NY 10003-4308

Phone

(212) 287-7211

Fax

(212) 287-7210

NPI assigned

Jun 5, 2020

Last updated

Feb 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brad Michael GandolfiNPI 1003131053

Title

Owner

Phone

(212) 287-7211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brad Michael Gandolfi, M.D.

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1003131053

  NJ

  Medicare reassignment Care Compare group Authorized official
• Brian Bassiri-Tehrani, MD

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
  • NPI 1386062800

  NJ

  Medicare reassignment Care Compare group
• Stephanie Acevedo, PA

  • Physician Assistant
  • Rutherford, NJ
  • NPI 1043892060
  Medicare reassignment
• Corrinn Lucotch, PA-C

  • Physician Assistant
  • New York, NY
  • NPI 1497626725
  NPD (past)
• David Peretz Rapaport, MD

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1134271521
  NPD (past)

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1942824867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 5TH AVE SUITE 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034308",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 5TH AVE",
            "address_2": "SUITE 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034308",
            "telephone_number": "212-287-7211",
            "fax_number": "212-287-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N Dean St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076312807",
            "country_code": "US",
            "telephone_number": "212-287-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HUDSON PLASTIC SURGERY NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "GANDOLFI",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-287-7211"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hudson Medical Westside, PLLC
• Hudson Mental Health Counseling, P.C.
• Hudson Neurology P.C.
• Hudson Orthopedics PLLC
• Hudson Pain Management Services, P.C.
• Hudson Podiatry PC
• Hudson Psychotherapy LCSW PLLC
• Hudson River Gynecology PC
• Hudson River Orthodontics, PC
• Hudson River Wellness LLC

• Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.