Individual provider Active NPI

Ryan M Staszak, M.D.

  • Surgery Physician
  • Hershey, PA
National Provider Identifier
1417105511
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD452524 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8887
Fax
(717) 531-0321
NPI assigned
Sep 3, 2008
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD452524 PA Primary
Surgery Physician 208600000X P23628 MD

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 1

IdentifierTypeStateIssuer
1029560520001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822002330 PA Practitioner - General Surgery 9537387147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P23628MDMDSurgery Physician
MD452524PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group Surgery CurrentSince Jul 21, 2014 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 21, 2014 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Past Accepting new patients

Locations

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#41
Hershey, PA 17033
Phone (717) 531-8202

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1417105511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8887",
            "fax_number": "717-531-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASZAK",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD452524",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "P23628",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029560520001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.