Individual provider Active NPI

Grace Elizabeth Gryzlo, MSN

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1316463524
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2017025300 Issued in MO
Practice address
1 Childrens PL
Saint Louis, MO 63110-1002
Phone
(314) 454-6000
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2017025300 MO Primary

Addresses

Primary practice location

1 Childrens PL
Saint Louis, MO 63110-1002

Mailing address

4447 Pershing Ave
Saint Louis, MO 63108-2507
Phone (708) 502-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001003289 WA Practitioner - Nurse Practitioner 0941629414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2017025300MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Sep 25, 2020 Accepting new patients
Seattle Children'S Hospital CurrentSince Sep 25, 2020 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4540 Sand Point Way NE
Seattle, WA 98105
Phone (206) 987-5629

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: ggryzlo93693@direct.seattlechildrens.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1316463524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4447 PERSHING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082507",
            "telephone_number": "708-502-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYZLO",
        "first_name": "GRACE",
        "middle_name": "ELIZABETH",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2017025300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.