ROY J GANDOLFI (MD) – Internal Medicine Physician, NPI 1740211101
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
903 INTERNAL MEDICINE in UT
Loading map...
Provider Addresses for ROY J GANDOLFI (MD)
4100 West, Country Meadows, West Valley City, Salt Lake County, Utah, 84120, United States
WEST VALLEY CITY, UT 84120
Phone: (801) 965-3600
Fax: (801) 965-3526
Type: Mailing
2965 W 3500 S
WEST VALLEY CITY, UT 841193602
Phone: (801) 965-3600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 60 Open Payments records for all available years, with a total value of $4,945.
Total Amount is formed as General ($4,945) + Research ($0) + Ownership ($0) = $4,945.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Gen-Probe, Inc. ($3,261).
Total Amount
$4,945
General + Research + Ownership
Payments
60
Total payment records
General Amount
$4,945
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-07-21
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 |
|---|---|---|---|---|
| I20040721000838 | I | Internal Medicine | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 498 | 279 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 219 | 219 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 161 | 116 | $0 |
| 85610 | Blood test, clotting time | 117 | 17 | $0 |
| G0008 | Administration of influenza virus vaccine | 88 | 84 | $0 |
Insurance plans in this area (ZIP 84120)
Loading plans...
Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| U R O L O G Y | UT | |
| - | UT | |
| Pain Management | UT | |
| Physician Assistant | UT | |
| - | UT | |
| Sports Medicine, Family Practice | UT | |
| - | UT | |
| Family Practice | UT | |
| Internal Medicine | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.