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DR. WALTER ANDREW GRYCZEWSKI JR. MD
NPI 1174371827
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since May 08, 2024PECOS Enrolled
4160 JOHN R ST STE 615, DETROIT, MI 48201(313) 745-4195(313) 993-8669 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Walter Andrew Gryczewski Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WALTER ANDREW GRYCZEWSKI JR. MD (NPI 1174371827) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174371827
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. WALTER ANDREW GRYCZEWSKI JR.Credential: MD
Location Address4160 JOHN R ST STE 615Detroit, MI 48201-2022
Mailing Address10063 Wyandot PlPerrysburg, OH 43551-3670 · (419) 787-3869
Phone(313) 745-4195
Fax(313) 993-8669
Sole ProprietorNo
Enumeration DateMay 8, 2024
NPPES CertifiedMay 8, 2024
✔ NPI 1174371827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4160 JOHN R ST STE 615, Detroit, MI 48201
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Walter Andrew Gryczewski Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM DEAN JACOBUS DO
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
ALFREDO MUNOZ-LAROCHE MD
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
VEDA VYAS GOKULA MD, MBA
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
ZAYD AYAS
Surgery
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
ROOZBEH MANSOUR MD
Surgery
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-8773
MR. MOHAMEDALMORTDA KHAIRALSEED MD
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
JESSICA A JOHNS MD
Emergency Medicine
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195
DR. MARILEE JA CLUNK M.D.
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 615
DETROIT, MI 48201
Wayne County (313) 745-4195

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walter Gryczewski's NPI number?

The NPI number for Walter Gryczewski is 1174371827. It was assigned to this individual provider in the NPPES registry on May 8, 2024.

Where is Walter Gryczewski located?

Walter Gryczewski practices at 4160 John R St Ste 615, Detroit, MI 48201. The listed phone number is (313) 745-4195.

What is Walter Gryczewski's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Walter Gryczewski enrolled in Medicare?

Yes. Walter Gryczewski is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Walter Gryczewski was last updated on May 8, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.