CHAUN GANDOLFO (DO) – Internal Medicine Physician, NPI 1720441884
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,218 INTERNAL MEDICINE in MI
Provider Addresses for CHAUN GANDOLFO (DO)
1215 E MICHIGAN AVE
LANSING, MI 489121811
Phone: (517) 364-1000
Type: Location
Henry Ford Hospital, 2799, West Grand Boulevard, New Center, Detroit, Wayne County, Michigan, 48202, United States
HENRY FORD HOSPITAL
DETROIT, MI 482022608
Phone: (313) 916-2600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 64 Open Payments records for all available years, with a total value of $7,545.
Total Amount is formed as General ($7,545) + Research ($0) + Ownership ($0) = $7,545.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: Boston Scientific Corporation ($5,000).
Total Amount
$7,545
General + Research + Ownership
Payments
64
Total payment records
General Amount
$7,545
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $5,000 |
| Medtronic, Inc. | $2,016 |
| Abbott Laboratories | $160 |
| Philips Electronics North America Corporation | $123 |
| Stereotaxis Inc | $94 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190712002470 | I | Internal Medicine | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48912)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| - | MI | |
| Family Practice | MI | |
| - | MI | |
| P A T H O L O G Y | IL | |
| Nurse Practitioner | MI | |
| Vascular Surgery, General Surgery | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine | MI | |
| Family Practice | MI |
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