NPIMap

Individual provider Active NPI

Julia Nicole Gruetzmacher, MD

  • Family Medicine Physician
  • Missoula, MT
National Provider Identifier
1962852962
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76116 Issued in MT
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 543-7271
Fax
(406) 327-1834
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 76116 MT Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 543-7271

Other practice location 1

401 Railroad St W
Missoula, MT 59802-4109
Phone (406) 258-4789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20190709001255 MT Practitioner - Family PracticePractitioner - Hospitalist 1355695792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 329-5828

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
  • Bitterroot Health - Daly Hospital Hospital, Hamilton, MT, CCN 271340
  • Community Medical Center Hospital, Missoula, MT, CCN 270023
  • Providence St Joseph Medical Center Hospital, Polson, MT, CCN 271343

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76116MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Family Medicine CurrentSince Jul 10, 2019 Accepting new patients
Providence Health & Services Mt CurrentSince Jul 10, 2019 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Past Accepting new patients

Locations

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

Organizations & group practices 4

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 7

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1962852962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-543-7271",
            "fax_number": "406-327-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-543-7271",
            "fax_number": "406-327-1834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Railroad St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024109",
            "country_code": "US",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUETZMACHER",
        "first_name": "JULIA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "76116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.