Zachery Tyler Staskywicz, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

RL15810 Issued in ND

Practice address

University of North Dakota SMHS Department of Surgery
1301 North Columbia Road Stop 9037
Grand Forks, ND 58202

Phone

(701) 293-4151

Fax

(701) 293-4148

NPI assigned

Jul 9, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

General Surgery

Education

University of North Dakota School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Range Regional Health Services Hospital, Hibbing, MN, CCN 240040

Merit-based Incentive Payment System (MIPS)

Final score

96.93 of 100Reported as group

Quality

94.88

Promoting interoperability

100

Improvement activities

40

Cost

78.21

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zstaskywicz1489887@fairview.direct-ci.com

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.

• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment Care Compare group NPD
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  NPD
• Range Regional Health Services

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  Care Compare affiliation

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1962054171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY",
            "address_2": "1301 NORTH COLUMBIA ROAD STOP 9037",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58202",
            "telephone_number": "701-293-4151",
            "fax_number": "701-293-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY",
            "address_2": "1301 NORTH COLUMBIA ROAD STOP 9037",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58202",
            "telephone_number": "701-293-4151",
            "fax_number": "701-293-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASKYWICZ",
        "first_name": "ZACHERY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "RL15810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casandra Anne Stanley, LICSW
• Hallee Morgan Stark
• Joseph Stark, LSW
• Katie Stark, MOTR/L
• Start Somewhere Counseling Services LLC
• Kelly Jean Stauss Carlson, NP-C
• Steady Hands LLC
• Stephanie R Steele, MSN, APRN
• Carla Steen, MS CCC-SLP
• Bob Steers, L.M.T.

• Surgery Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.