Individual provider Active NPI

Amy T Grulke, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Chandler, AZ
National Provider Identifier
1164607628
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLPL5749 Issued in AZ
Practice address
2248 N Alma School Rd Ste 102
Chandler, AZ 85224-2488
Phone
(480) 935-0614
NPI assigned
Jan 3, 2008
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLPL5749 AZ Primary

Addresses

Primary practice location

2248 N Alma School Rd Ste 102
Chandler, AZ 85224-2488

Mailing address

2322 W Stottler Dr
Chandler, AZ 85224-2524
Phone (480) 247-9693

Other identifiers 1

IdentifierTypeStateIssuer
412169MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108001380 AZ Practitioner - Qualified Speech Language Pathologist 7618242728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amy Grulke PLLCGroup PAC ID 4284992538, 9 clinicians

Practice addresses (Care Compare)

2248 N Alma School Rd
Suite 102
Chandler, AZ 85224-2488
Phone (480) 935-0614

5750 W Thunderbird Rd
Suite E500
Glendale, AZ 85306-4669
Phone (480) 935-0614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLPL5749AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Grulke, PLLC Speech-Language Pathologist CurrentSince Aug 1, 2017 Accepting new patients

Locations

2248 N Alma School Rd
Ste 102
Chandler, AZ 85224
Phone (480) 899-9484

2950 N Dobson Rd
Ste 3
Chandler, AZ 85224
Phone 4809350614407

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1164607628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 W STOTTLER DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242524",
            "telephone_number": "480-247-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 N ALMA SCHOOL RD STE 102",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242488",
            "telephone_number": "480-935-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULKE",
        "first_name": "AMY",
        "middle_name": "T",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLPL5749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412169",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.