Individual provider Active NPI

Matthew P. Grimm, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • New York, NY
National Provider Identifier
1275732745
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
261275 Issued in NY
Practice address
160 E 56TH St FL 11
New York, NY 10022-3609
Phone
(212) 371-4060
NPI assigned
Jul 16, 2007
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301090861 MI
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 261275 NY Primary

Addresses

Primary practice location

160 E 56TH St FL 11
New York, NY 10022-3609

Mailing address

160 E 56TH St FL 11
New York, NY 10022-3609
Phone (212) 371-4060

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120910000450 NY Practitioner - Pain ManagementPractitioner - Physical Medicine and RehabilitationPractitioner - Interventional Radiology 8123276532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Interventional Radiology, Physical Medicine and Rehabilitation
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Ny Ortho, Sports Medicine, and Trauma, P.C.Group PAC ID 0547436388, 2 clinicians

Practice addresses (Care Compare)

160 E 56TH St
New York, NY 10022-3609
Phone (212) 371-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301090861MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Ortho, Sports Medicine, & Trauma, P.C. Multi-Specialty CurrentSince Aug 8, 2011 Accepting new patients

Locations

160 E 56th St
Fl 10
New York, NY 10022
Phone (212) 371-4060

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1275732745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E 56TH ST FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223609",
            "telephone_number": "212-371-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E 56TH ST FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223609",
            "telephone_number": "212-371-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "MATTHEW",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301090861",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "261275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.