Provider Type Icon

GRANT NYBAKKEN M.D. NPI 1104088400


NPI Information

NPI: 1104088400
Provider Name: GRANT NYBAKKEN, M.D.
Classification: Pathology - 207ZP0105X
Entity Type: Individual

Specialization: Clinical Pathology/Laboratory Medicine

Organization: PERMANENTE MEDICAL GROUP INC

PECOS Registration: Yes

Address:
3400 SPRUCE ST
1 MALONEY
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-3957
Get Directions

Grant Nybakken, M.D. is a clinical pathology/laboratory medicine pathology in Philadelphia, PA with 16 years of experience. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. Grant Nybakken, M.D. NPI is 1104088400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

3400 SPRUCE ST
1 MALONEY
PHILADELPHIA, PA
ZIP 19104-238
Phone: (215) 662-3957

The NPI 1104088400 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2008 and was last updated on 12/15/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ZP0105XPathologyClinical Pathology/Laboratory MedicineMT193042PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.