Dr Lisa Deette Staber, MD in Grand Rapids, MN

Dr Lisa Deette Staber, MD is a medicare enrolled "Family Medicine" physician in Grand Rapids, Minnesota. She went to Sanford School Of Medicine Of University Of South Dakota and graduated in 1987 and has 37 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice State Of Michigan Office Of Financial Management and her current practice location is 20635 Mishawaka Shores Trl, Grand Rapids, Minnesota. You can reach out to her office (for appointments etc.) via phone at (218) 398-0256.

Dr Lisa Deette Staber is licensed to practice in Minnesota (license number 38922) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629035308.

Contact Information

	Dr Lisa Deette Staber, MD
	20635 Mishawaka Shores Trl, Grand Rapids, MN 55744-6071
	(218) 398-0256
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Lisa Deette Staber
Gender	Female
Speciality	Family Practice
Experience	37 Years
Location	20635 Mishawaka Shores Trl, Grand Rapids, Minnesota
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Lisa Deette Staber attended and graduated from Sanford School Of Medicine Of University Of South Dakota in 1987

NPI Data:

NPI Number: 1629035308
Provider Enumeration Date: 04/27/2006
Last Update Date: 05/09/2017

Medicare PECOS Information:

PECOS PAC ID: 8123915444
Enrollment ID: I20060417000520

Medical Identifiers

Medical identifiers for Dr Lisa Deette Staber such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629035308	NPI	-	NPPES
4848740	Medicaid	MI
P00328166	Other		RR-MEDICARE
P00328166	Other	MI	RR-MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	4301086765 (Michigan)	Secondary
207Q00000X	Family Medicine	38751-020 (Wisconsin)	Secondary
207Q00000X	Family Medicine	38922 (Minnesota)	Primary
207Q00000X	Family Medicine	38751-20 (Wisconsin)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
State Of Michigan Office Of Financial Management	5496650723	44

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Lisa Deette Staber allows following entities to bill medicare on her behalf.

Entity Name	State Of Michigan Office Of Financial Management
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508883299 PECOS PAC ID: 5496650723 Enrollment ID: O20040114000603

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lisa Deette Staber is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Lisa Deette Staber, MD 20635 Mishawaka Shores Trl, Grand Rapids, MN 55744-6071 Ph: (218) 398-0256	Dr Lisa Deette Staber, MD 20635 Mishawaka Shores Trl, Grand Rapids, MN 55744-6071 Ph: (218) 398-0256

Reviews and Comments

Family Medicine Doctors in Grand Rapids, MN

Dr. Patricia C. Carlin-janssen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Anne Eileen Tofte, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Dr. Edwin A. Anderson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Kristin A Johnson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 409 Se 13th St, Grand Rapids, MN 55744 Phone: 218-326-9100 Fax: 218-326-9200
Dr. Timothy J. Pehl, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Dr. Michael B. Liebe, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-326-5000
Arie Degrio, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1601 Golf Course Rd, Grand Rapids, MN 55744 Phone: 218-999-1442 Fax: 218-999-1461

Dr Lisa Deette Staber, MD - Medicare Family Practice in Grand Rapids, MN