| Dr Richard S Stack, MD | |
|
1 Jarrett White Rd, Tripler Army Medical Center, Attn: Mchk-qs, Tripler Amc, HI 96859-5001 | |
| (808) 433-2460 | |
| (808) 433-1558 |
| Full Name | Dr Richard S Stack |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 40 Years |
| Location | 1 Jarrett White Rd, Tripler Amc, Hawaii |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376519017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD-14129 (Hawaii) | Secondary |
| 208800000X | Urology | MA50961 (New Jersey) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hilo Medical Center | Hilo, HI | Hospital |
| Kau Hospital | Pahala, HI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hilo Benioff Medical Center | 1254422900 | 98 |
| Kau Hospital | 7416945548 | 114 |
| Entity Name | Kau Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144304338 PECOS PAC ID: 7416945548 Enrollment ID: O20040601000398 |
| Entity Name | Hilo Benioff Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962584060 PECOS PAC ID: 1254422900 Enrollment ID: O20070809000268 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard S Stack, MD 1 Jarrett White Rd, Tripler Army Medical Center, Attn: Mchk-qs, Tripler Amc, HI 96859-5001 Ph: (808) 433-2460 | Dr Richard S Stack, MD 1 Jarrett White Rd, Tripler Army Medical Center, Attn: Mchk-qs, Tripler Amc, HI 96859-5001 Ph: (808) 433-2460 |
Ernesto Montecillo Padilla, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center Attn:mchk-qs, Tripler Amc, HI 96859 Phone: 808-433-2460 | |
Dr. William Gilliam Kennon Iii, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center, Tripler Amc, HI 96859 Phone: 808-433-2460 Fax: 808-433-1558 |