NPIMap

Individual provider Active NPI

Matthew Michael Grinsell, M.D., PH.D.

  • Pediatric Nephrology Physician
  • Salt Lake City, UT
National Provider Identifier
1346364429
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
65474331205 Issued in UT
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 587-7575
Fax
(801) 581-8043
NPI assigned
Mar 16, 2007
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 65474331205 UT Primary

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 413021
Salt Lake City, UT 84141-3021
Phone (801) 213-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgrinsell35550@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080306000368 UT Practitioner - Pediatric MedicinePractitioner - Nephrology 3870678469 Reassigns benefits to 2 organizations
I20190422000970 MT Practitioner - Pediatric Medicine 3870678469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Nephrology
Education
University of Nevada School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 213-3599

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65474331205UTMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Apr 1, 2019 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 1, 2007 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Apr 1, 2019 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 1, 2016 Accepting new patients
Ihc Health Services Inc Pediatric Nephrology Current Accepting new patients
Ihc Health Services Inc CurrentSince Sep 1, 2007 Accepting new patients
University of Utah Pediatric Services Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1232 N 30th St
Ste 200
Billings, MT 59101
Phone (406) 237-5300

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1346364429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413021",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413021",
            "telephone_number": "801-213-3900",
            "fax_number": "801-585-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-587-7575",
            "fax_number": "801-581-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINSELL",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "UT",
            "license": "65474331205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrinsell35550@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.