Marek A Stawiski, MD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

4301030349 Issued in MI

Practice address

833 Michigan St NE
Suite 102
Grand Rapids, MI 49503-3523

Phone

(616) 459-8209

Fax

(616) 459-0313

NPI assigned

Jul 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Dermatology

Education

University of Michigan Medical School, 1970

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Psoriasis and Eczema Treatment Center of Western Michigan PLLC

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1396745055
  NPD Authorized official
• Dermatology Center of Grand Rapids PC

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1275527053
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1679573331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAWISKI",
        "first_name": "MAREK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MI",
            "license": "4301030349",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301030349",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0724106641",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4687587",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB MEDICARE",
            "identifier": "P00236428",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Maile Statler
• Ella Kate Stauffer, PA-C
• Natalie Stauffer, O.T.R.L.
• Susan K Stauffer, LMSW
• Sarah Dian Stawicki, PA-C
• Marisha Irene Stawiski, D.P.M
• Steady Mind PLLC
• Desiree Diane Stearns
• Thuy-Tien Ngoc Stearns, PA-C
• Austin Robert Stebbins, DDS

• Dermatopathology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dermatopathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.