Matylin F Grutzmacher, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22489 Issued in MN

Practice address

1312 2ND St NE
Minneapolis, MN 55413-1132

Phone

(612) 839-9386

Fax

(833) 933-0639

NPI assigned

Oct 11, 2023

Sex

Female

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Accend Services Incorporated

  • Adult Mental Health Clinic/Center
  • Duluth, MN
  • NPI 1417023458
  Medicare reassignment NPD

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1225819667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022086",
            "telephone_number": "218-724-3122",
            "fax_number": "833-933-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131132",
            "telephone_number": "612-839-9386",
            "fax_number": "833-933-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022086",
            "country_code": "US",
            "telephone_number": "218-724-3122",
            "fax_number": "833-933-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUTZMACHER",
        "first_name": "MATYLIN",
        "middle_name": "F",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Grunewald, M.D.
• Tiffany Kaye Grunewald, DPT
• Amy Christine Grunzke
• Che'Cail Jiah Maree Gruse
• Christine Choshi Grussing
• Gretchen Helen Gruys, FNP
• Catherine Ann Gryzmala, CRNA
• Susan Marie Grzywinski, RN
• GT Urological, LLC
• GTM Enterprises PA

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.