Pawel P Stachowicz, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

39698 Issued in MN

Practice address

3005 Knox Ave S
Minneapolis, MN 55408-2542

Phone

(612) 770-1995

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Plastic Surgery Consultants, LTD.

  • Medical Specialty Clinic/Center
  • Edina, MN
  • NPI 1801055066
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1699862490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE #260",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "612-360-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 KNOX AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082542",
            "telephone_number": "612-770-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHOWICZ",
        "first_name": "PAWEL",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "39698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3843254000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randal Richard Staats
• Stability Pro LLC
• Stable Care Services LLC
• Stable Housing LLC
• Stable Living Solutions LLC
• Jenna Renee Stade
• Amanda Stadem, DO
• Sarah Marie Stadie
• Mary J Stadler, MA, LPCC, LADC
• Steven James Stadler, MA LADC LPCC

• Plastic Surgery Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Plastic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.