Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TIMOTHY ROBERT GANDOLFO DO
NPI 1891375671
Family Medicine in Stony Brook, NY

Q: What is Timothy Gandolfo's NPI number?

The NPI number for Timothy Gandolfo is 1891375671. It was assigned to this individual provider in the NPPES registry on April 14, 2021.

Q: What is Timothy Gandolfo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Gandolfo was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days 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.

Active since April 14, 2021PECOS Enrolled

101 COUNTY RD 97, STONY BROOK, NY 11794(631) 689-8333 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 6, 2024, Apr 14, 2021 (2 updates tracked since 2021).

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About Dr. Timothy Robert Gandolfo Do NPPES

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

DR. TIMOTHY ROBERT GANDOLFO DO (NPI 1891375671) is an individual family medicine provider in Stony Brook, New York, licensed in New York (330997) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891375671

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. TIMOTHY ROBERT GANDOLFOCredential: DO

Location Address101 COUNTY RD 97Stony Brook, NY 11794-0001

Mailing Address101 County Rd 97Stony Brook, NY 11794-0001

Phone(631) 689-8333

Sole ProprietorNo

Enumeration DateApril 14, 2021

Last NPPES UpdateJune 30, 20262 updates tracked since enumeration

NPPES CertifiedJune 30, 2026

✔ NPI 1891375671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 330997

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

101 COUNTY RD 97, Stony Brook, NY 11794

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy Robert Gandolfo Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

43 services43 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

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

TASIYAH ESSOP MD

Student in an Organized Health Care Education/Training Program