NPIMap

Individual provider Active NPI

Amy Grzysiewicz, D.O.

  • Family Medicine Physician
  • Portland, ME
National Provider Identifier
1558521807
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2232 Issued in ME
Practice address
331 Veranda St
Portland, ME 04103-5545
Phone
(072) 828-2402
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2232 ME Primary

Addresses

Primary practice location

331 Veranda St
Portland, ME 04103-5545

Mailing address

PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.grzysiewicz.1@5857.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000524 ME Practitioner - Family Practice 6305017005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians

Practice addresses (Care Compare)

331 Veranda St
Portland, ME 04103-5545
Phone (207) 828-2402

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2232MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Family Medicine CurrentSince Nov 7, 2022 Accepting new patients
York Hospital Family Medicine CurrentSince Aug 1, 2011 Accepting new patients
Seacoast Pathology Inc Current Accepting new patients

Locations

22 Shapleigh Rd
Kittery, ME 03904
Phone (207) 439-4430

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1558521807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 VERANDA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035545",
            "telephone_number": "072-828-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZYSIEWICZ",
        "first_name": "AMY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "2232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.grzysiewicz.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "331 Veranda St",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041035545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.