NPIMap

Individual provider Active NPI

Matthew Drew Grunwald, M.D.

  • Gastroenterology Physician
  • Portland, ME
National Provider Identifier
1689061954
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD25916 Issued in ME
Practice address
161 Marginal Way
Portland, ME 04101-2438
Phone
(207) 773-7964
Fax
(207) 773-9073
NPI assigned
Apr 23, 2015
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD25916 ME Primary

Addresses

Primary practice location

161 Marginal Way
Portland, ME 04101-2438

Mailing address

161 Marginal Way
Portland, ME 04101-2438
Phone (207) 773-7964

Other practice location 1

48 Gilman St
Portland, ME 04102-3004
Phone (207) 661-4400

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
I20220727000155 ME Practitioner - Gastroenterology 5395080360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Gastroenterology Associates PAGroup PAC ID 5193702967, 22 clinicians

Practice addresses (Care Compare)

161 Marginal Way
Portland, ME 04101-2438
Phone 2077737964232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy65
Upper gastrointestinal (GI) endoscopy for acid reflux121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25916MEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 12, 2023 Accepting new patients
Maine Medical Partners CurrentSince Jan 12, 2023 Accepting new patients
Portland Gastroenterology Associates P.a. Gastroenterology CurrentSince Sep 12, 2022 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Jan 12, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jan 12, 2023 Accepting new patients
Portland Endoscopy Center Past Accepting new patients

Locations

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

48 Gilman St
Portland, ME 04102
Phone (207) 661-4400

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

Interoperability endpoints

  • Direct secure messaging: mgrunwald554299@direct.mmc.mainehealth.org

Organizations & group practices 8

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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1689061954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Gilman St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023004",
            "country_code": "US",
            "telephone_number": "207-661-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNWALD",
        "first_name": "MATTHEW",
        "middle_name": "DREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD25916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.