Matthew A Stack, PA C is a medicare enrolled "Physician Assistant" provider in Ithaca, Michigan. He graduated from medical school in 2002 and has 24 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Genesee Health System and 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 | Physician Assistant |
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| Experience | 24 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 graduated from medical school in 2002
NPI Data:
- NPI Number: 1033108667
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 05/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 4981896685
- Enrollment ID: I20101013000935
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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