Matthew A Stack, PA C is a medicare enrolled "Physician Assistant" provider in Ithaca, Michigan. His current practice location is
121 N Pine River St, Ithaca, Michigan. You can reach out to his office (for appointments etc.) via phone at
(989) 287-0662.
Matthew A Stack is licensed to practice in Michigan (license number 5601003961) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1033108667.
Healthcare Provider's Profile
| Full Name | Matthew A Stack |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 121 N Pine River St, Ithaca, Michigan |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Matthew A Stack attended and graduated from in
NPI Data:
- NPI Number: 1033108667
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 05/10/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Matthew A Stack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033108667 | NPI | - | NPPES |
| P00140431 | Other | AZ | RAILROAD |
| 0852900260 | Other | MI | BCBSM |
| 762246 | Medicaid | AZ | |
| 50155318 | Other | NM | MEDICAID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 6301007939 (Michigan) | Secondary |
| 363A00000X | Physician Assistant | 2782 (Arizona) | Secondary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | 5601003961 (Michigan) | Primary |
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. Matthew A Stack 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 |
|---|
Matthew A Stack, PA C
121 N Pine River St,
Ithaca, MI 48847-1039
Ph: (989) 287-0662 | Matthew A Stack, PA C
121 N Pine River St,
Ithaca, MI 48847-1039
Ph: (989) 287-0662 |
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