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DR. LISA DEETTE STABER MD
NPI 1629035308
Family Medicine in Grand Rapids, MN

Active since April 27, 2006PECOS Enrolled
20635 MISHAWAKA SHORES TRL, GRAND RAPIDS, MN 55744(218) 398-0256 Get Directions Write a Review

NPPES record last updated: May 9, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Lisa Deette Staber Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA DEETTE STABER MD (NPI 1629035308) is an individual family medicine provider in Grand Rapids, Minnesota, licensed in Minnesota (38922) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Avera Granite Falls, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (1987).

NPPES Registry Identity

NPI1629035308
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. LISA DEETTE STABERCredential: MD
Location Address20635 MISHAWAKA SHORES TRLGrand Rapids, MN 55744-6071
Mailing Address20635 Mishawaka Shores TrlGrand Rapids, MN 55744-6071 · (218) 398-0256
Phone(218) 398-0256
Sole ProprietorYes
Medical School CMSSanford School Of Medicine Of University Of South DakotaGraduated 1987
Enumeration DateApril 27, 2006
Last NPPES UpdateMay 9, 2017
✔ NPI 1629035308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in MN · 38922✔ Licensed in WI · 38751-20✔ Licensed in WI · 38751-020✔ Licensed in MI · 4301086765
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
20635 MISHAWAKA SHORES TRL, Grand Rapids, MN 55744
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Other Identifiers 8

OtherP00328166MI · Rr-medicare
Medicare PINN41200006
Medicaid4848740MI
OtherP00328166Rr-medicare
Medicare UPINF80212MI
Medicare NSC4825080002MI
Medicare UPINF80212
Medicare NSC4825080002

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa Deette Staber Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123915444
PECOS Enrollment IDI20040302000526, I20060417000520
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Avera Granite Falls

Critical Access Hospitals · Granite Falls, MN
OwnershipGovernment - Local
CMS Certification Number241343
Location345 Tenth AvenueGranite Falls, MN 56241 · Yellow Medcine County
Emergency services

Avera Tyler Hospital

Critical Access Hospitals · Tyler, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241348
Location240 Willow StreetTyler, MN 56178 · Lincoln County
Emergency services

Avera Marshall Regional Medical Ctr

Critical Access Hospitals · Marshall, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number241359
Location300 South Bruce StreetMarshall, MN 56258 · Lyon County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55744 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Staber's NPI number?

The NPI number for Lisa Staber is 1629035308. It was assigned to this individual provider in the NPPES registry on April 27, 2006.

Where is Lisa Staber located?

Lisa Staber practices at 20635 Mishawaka Shores Trl, Grand Rapids, MN 55744. The listed phone number is (218) 398-0256.

What is Lisa Staber's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lisa Staber enrolled in Medicare?

Yes. Lisa Staber is registered in the Medicare PECOS enrollment system.

What insurance does Lisa Staber accept?

Health plans from Avera Health Plans and Sanford Health Plan list Lisa Staber as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Staber affiliated with any hospitals?

According to CMS data, Lisa Staber is affiliated with Avera Granite Falls, Avera Tyler Hospital and Avera Marshall Regional Medical Ctr.

When was this NPI record last updated?

The NPPES record for Lisa Staber was last updated on May 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.