2026 NPPES data Otolaryngology Physician NPI 1538486196 M.D.
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MICHELE GANDOLFI, M.D.

Otolaryngology Physician in WINSTON SALEM, North Carolina. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
218
Medicare Part D claims · 81 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
89%
generic claims · 11% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
98.3/100
▲ 15 pts above national avg 83.1 · [object Object]

What the federal data shows

MICHELE GANDOLFI, M.D. reported a CMS MIPS final score of 98.3/100 — above the 83.1 national average — and filed 218 Medicare Part D claims in 2023.

98.3/100
MIPS score · +15 vs avg
218
Part D claims, 2023
89%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

MICHELE GANDOLFI, M.D.'s MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

98 Top 11% higher than 89% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

MICHELE GANDOLFI, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about MICHELE GANDOLFI, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 04/22/2010

NPI 1538486196

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

218 57% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

98.3/100 15.200000000000003% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in North Carolina

How Otolaryngology Physician compares to other specialties among North Carolina providers

North Carolina providers

Otolaryngology Physician share within North Carolina

1. Otolaryngology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Otolaryngology Physician share within North Carolina

Medicare quality performance — MIPS

MICHELE GANDOLFI, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

High performer (top quartile)
MIPS Final Score
98.3/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 98.3/100 vs national avg 83.1

0%100%National avg83%98.3%
MIPS final score (Otolaryngology Physician) — 98.3/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

MICHELE GANDOLFI, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at MEDICAL CENTER BLVD, WINSTON SALEM, NC, 27157, with a listed phone of (336) 716-2255. NPI 1538486196 was issued on 04/22/2010. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GANDOLFI most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 218 prescription claims written by this provider, covering 81 Medicare beneficiaries and totaling roughly $7K in drug spend, split 11% brand-name and 89% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 98.3/100 for the 2023 performance year, compared with the national average of 83.1.

Otolaryngology Physician is a mid-sized specialty nationwide, with 10,895 enrolled providers across 54 states and an average of 509 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157

Provider Details

NPI 1538486196
Specialty Otolaryngology Physician
Credentials M.D.
Gender Female
NPI Issued 04/22/2010

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

98.3
Final Score
Avg: 83.1
98
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where MICHELE GANDOLFI, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

WAKE FOREST UNIVERSITY HEALTH SCIENCES
WINSTON SALEM, NC

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Brand vs generic prescribing mix · Typical

MICHELE GANDOLFI, M.D. — brand share 11.0%
Specialty average (est.)

11% brand-name claims vs 89% generic, on 218 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

218
Total Claims
$7K
Total Drug Cost
81
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
288
Total Day Supply
5,590
Brand vs Generic
11% brand / 89% generic
Brand Drug Cost
$3K
Generic Drug Cost
$5K
Antibiotic Claims
20

Patient Demographics

Average Patient Age
69.2 years
Avg HCC Risk Score
1.39
Gender Split
54% female / 46% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What MICHELE GANDOLFI, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Hydrochlorothiazide
24
Ofloxacin
24
Dexamethasone Sodium Phosphate
20
Ciprofloxacin-Dexamethasone
Ciprofloxacin Hcl/Dexameth
17
Potassium Chloride
17
Meclizine Hcl
14
Prednisone
14
Sulfamethoxazole-Trimethoprim
Sulfamethoxazole/Trimethoprim
13

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Otolaryngology Physician Overview

How MICHELE GANDOLFI, M.D. fits within the Otolaryngology Physician landscape nationally.

10,895
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider

MICHELE GANDOLFI, M.D.'s 218 claims are below the specialty average of 509.

Nearby Otolaryngology Physician Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as GANDOLFI.

Compare Otolaryngology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is MICHELE GANDOLFI, M.D.'s specialty?
MICHELE GANDOLFI, M.D. specializes in Otolaryngology Physician and practices in WINSTON SALEM, North Carolina. Credentials: M.D..
How much does MICHELE GANDOLFI, M.D. prescribe under Medicare Part D?
In 2023, MICHELE GANDOLFI, M.D. wrote 218 Medicare Part D claims totaling $7K in drug costs for 81 beneficiaries.
What is MICHELE GANDOLFI, M.D.'s Medicare quality score?
MICHELE GANDOLFI, M.D. has a CMS MIPS Final Score of 98.3/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is MICHELE GANDOLFI, M.D. located?
MICHELE GANDOLFI, M.D. is located at MEDICAL CENTER BLVD, WINSTON SALEM, NC, 27157. Phone: (336) 716-2255.
What is MICHELE GANDOLFI, M.D.'s NPI number?
MICHELE GANDOLFI, M.D.'s National Provider Identifier (NPI) is 1538486196, issued on 04/22/2010.
Does MICHELE GANDOLFI, M.D. prescribe more brand-name or generic drugs?
MICHELE GANDOLFI, M.D.'s prescribing is 11% brand-name and 89% generic drugs by claim count, with $3K in brand drug costs.
How many Otolaryngology Physician providers are there in the US?
There are 10,895 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does MICHELE GANDOLFI, M.D. prescribe most often?
Based on 2023 Medicare Part D data, MICHELE GANDOLFI, M.D.'s most frequently prescribed drugs include Hydrochlorothiazide, Ofloxacin, Dexamethasone Sodium Phosphate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does MICHELE GANDOLFI, M.D. accept Medicare?
MICHELE GANDOLFI, M.D. appears in CMS Medicare data with 218 Part D claims and 81 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify MICHELE GANDOLFI, M.D.'s credentials?
MICHELE GANDOLFI, M.D.'s NPI is 1538486196 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology