Justyna Grothaus, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2011019203 Issued in MO

Practice address

1 Childrens PL # 3S34
Saint Louis, MO 63110-1002

Phone

(314) 454-6006

NPI assigned

Jul 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1710274808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO",
            "address_2": "BOX 45",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL # 3S34",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHAUS",
        "first_name": "JUSTYNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036135503",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011019203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Grossman, FNP-C
• Steven Paul Grossman, DDS
• Leonard E Grosso, MD PHD
• Caleb W Grote, MD
• Kevin E. Groth, DMD
• Morgan Elizabeth Grothaus, BSN, MSN, RN, FNP
• Margaret Clare Grotpeter, LPC
• Grounded State Psychotherapy LLC
• Nathan Groves
• Growe Counseling LLC

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.