Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grant William Mathison

Individual provider Orthopaedic Surgery Physician · NPI 1629482708

Grant William Mathison is an Orthopedic Surgery in Shakopee, Minnesota. Graduated from University of Minnesota Medical School in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Minnesota.

Years since qualifying
12
Trained at
University of Minnesota Medical School
Licensed in
MI, MN
In the registry since
2014
Specialties on file
2

Practice location Address checks out

1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone: (952) 993-7750
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 Lafayette Ave Se, Grand Rapids, MI 49503-4692 — (616) 685-6920

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 67362 (MN)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 4301105237 (MI)

Record details

NPI number1629482708
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 17, 2014
Last updated in NPPESJuly 30, 2020
Certification dateJuly 30, 2020
Mailing address1415 Saint Francis Ave, Shakopee, MN 55379-3374

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Shakopee