Walter Andrew Gryczewski Jr., MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4160 John R St Ste 615
Detroit, MI 48201-2022

Phone

(313) 745-4195

Fax

(313) 993-8669

NPI assigned

May 8, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: wgryczewski3611085@direct.trinity-health.org

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1174371827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10063 WYANDOT PL",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513670",
            "telephone_number": "419-787-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 615",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012022",
            "telephone_number": "313-745-4195",
            "fax_number": "313-993-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYCZEWSKI",
        "first_name": "WALTER",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Grundy, CNP
• Jenny L Grunwald, P.A.-C
• Shaindy Grunwald, MD
• Matthew Francis Gruse, MS, ACSM CEP
• Meredith Grycki, PHARMD
• David John Gryniewicz, MD
• Cynthia Grywalski, M.A., CCC-SLP
• GSP Global LLC
• GST Pharmacy LLC (Jordan's Discount Pharmacy)
• Cristy A. Guagenti, CPNP

• Student in an Organized Health Care Education/Training Program in Detroit, MI
• Providers in Detroit, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.