Nicole Paige Grunzke-Lynner, PSY.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4347 Issued in MN

Practice address

2388 University Ave W
#207
Saint Paul, MN 55114-1769

Phone

(952) 210-1360

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1437106770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8855 RIVER HEIGHTS WAY",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550763479",
            "telephone_number": "651-554-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 UNIVERSITY AVE W",
            "address_2": "#207",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141769",
            "telephone_number": "952-210-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNZKE-LYNNER",
        "first_name": "NICOLE",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "557344100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "156M3GR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID",
            "identifier": "6142042",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "61-42042",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bria Lynn Grudzielanek, MSW
• Alexis Gruenhagen, MD
• Ian Grunberg, D.C.
• Sharon Elaine Grundtner, CNP
• Gabrielle Grunewald
• Shawn Grygo, LADC
• Alexandra Grace Gryskiewicz
• Ashley Gryskiewicz, LICSW
• Stephen Gryzan, MD
• GS Transportation LLC (Gostat Transportation LLC)

• Clinical Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.