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HAYDEN GANDOLFI
NPI 1720722218
Speech-Language Pathologist in Longview, WA

Active since April 21, 2022
2715 LILAC ST, LONGVIEW, WA 98632(360) 575-7000 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Hayden Gandolfi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAYDEN GANDOLFI (NPI 1720722218) is an individual speech-language pathologist provider in Longview, Washington, licensed in Michigan (7101007378) and active in the NPI registry since April 2022. He is a graduate of Other (2019).

NPPES Registry Identity

NPI1720722218
Entity TypeIndividualMale
Primary Taxonomy235Z00000X
Provider Legal NameHAYDEN GANDOLFI
Location Address2715 LILAC STLongview, WA 98632-3526
Mailing Address27077 Dartmouth StMadison Heights, MI 48071-3235
Phone(360) 575-7000
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 21, 2022
NPPES CertifiedApril 21, 2022
✔ NPI 1720722218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MI · 7101007378
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
2715 LILAC ST, Longview, WA 98632
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hayden Gandolfi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880164151
PECOS Enrollment IDI20260528000229

Medicare Billing Reassignment

Medicare enrollment records show Hayden Gandolfi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ivyrehab Michigan, LLC
1,934 mi
Sports Medicine
400 ROUNDS DR
Fenton, MI 48430
  • Reassigned Medicare billing, Michigan enrollment
  • 339 clinicians in this Medicare group
NPI 1104337120 (810) 750-1996

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN KYRTIS MONTANO OTR
Occupational Therapist
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7000
JESSICA DOUGHTY DPT, PT
Physical Therapist (Pediatrics)
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7019
NANCY ROSEANN D'URSO SLP-CCC
Speech-Language Pathologist
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7000
JOAN CASCIATO CARPENTER M.A, CCC-SLP
Speech-Language Pathologist
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7000
SHAWNA OLSON RN
Registered Nurse (School)
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7431
REBECCA SUE BAUMGARDNER M.ED., OTR/L
Occupational Therapist (Pediatrics)
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7008
LISA DIANE LYONS RN
Registered Nurse (School)
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 270-0477
KRYSTLE SPURLING LPN
Licensed Vocational Nurse
2715 LILAC ST
LONGVIEW, WA 98632
Cowlitz County (360) 575-7676

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hayden Gandolfi's NPI number?

The NPI number for Hayden Gandolfi is 1720722218. It was assigned to this individual provider in the NPPES registry on April 21, 2022.

Where is Hayden Gandolfi located?

Hayden Gandolfi practices at 2715 Lilac St, Longview, WA 98632. The listed phone number is (360) 575-7000.

What is Hayden Gandolfi's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Hayden Gandolfi enrolled in Medicare?

Yes. Hayden Gandolfi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Hayden Gandolfi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hayden Gandolfi reassigns Medicare benefits to Ivyrehab Michigan, LLC (Fenton, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hayden Gandolfi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hayden Gandolfi accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Hayden Gandolfi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hayden Gandolfi was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.