DR. ZACHERY TYLER STASKYWICZ MD
NPI 1962054171
Surgery in Grand Forks, ND
About Dr. Zachery Tyler Staskywicz Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ZACHERY TYLER STASKYWICZ MD (NPI 1962054171) is an individual surgery provider in Grand Forks, North Dakota, licensed in North Dakota (RL15810) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with University Medical Center-mesabi/ Mesaba Clinics, and is a graduate of University Of North Dakota School Of Medicine (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Zachery Tyler Staskywicz Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Zachery Staskywicz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hibbing, MN 55746
- Reassigned Medicare billing, Minnesota enrollment
- 707 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Medical Center-Mesabi/ Mesaba Clinics
Acute Care Hospitals · Hibbing, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 58202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRAND FORKS, ND 58202
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 Zachery Staskywicz's NPI number?
The NPI number for Zachery Staskywicz is 1962054171. It was assigned to this individual provider in the NPPES registry on July 9, 2019.
Where is Zachery Staskywicz located?
Zachery Staskywicz practices at University Of North Dakota Smhs Department Of Surgery 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202. The listed phone number is (701) 293-4151.
What is Zachery Staskywicz's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Zachery Staskywicz enrolled in Medicare?
Yes. Zachery Staskywicz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Zachery Staskywicz's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Zachery Staskywicz reassigns Medicare benefits to Range Regional Health Services (Hibbing, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Zachery Staskywicz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Zachery Staskywicz affiliated with any hospitals?
According to CMS data, Zachery Staskywicz is affiliated with University Medical Center-Mesabi/ Mesaba Clinics.
When was this NPI record last updated?
The NPPES record for Zachery Staskywicz was last updated on July 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Dr. Zachery Tyler Staskywicz, MD · NPI 1962054171
Surgery physician in Grand Forks, North Dakota. Individual provider, active in the CMS NPPES registry since July 9, 2019.
## Identity
- **NPI:** 1962054171 (Entity type: Individual)
- **Enumerated:** July 9, 2019
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** RL15810 (North Dakota)
- **Sole proprietor:** Yes
## Practice location
- **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
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Range Regional Health Services (NPI 1356321699, Hibbing, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of North Dakota School Of Medicine, class of 2019
## Record status
- **NPPES last updated:** July 9, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1962054171) · Data from the CMS NPPES public registry.