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, Trauma And Addiction Solutions, Pllc 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 |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 24 Years |
|---|
| Location | 121 N Pine River St, Ithaca, Michigan |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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: 02/05/2026
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 |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 103T00000X | Psychologist | 6301007939 (Michigan) | Secondary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | 2782 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | 5601003961 (Michigan) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Genesee Health System | 6002051091 | 36 |
| Trauma And Addiction Solutions, Pllc | 3577903913 | 2 |
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. Matthew A Stack allows following entities to bill medicare on his behalf.
| Entity Name | Mymichigan Medical Center Alma |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1568914422 PECOS PAC ID: 3375451404 Enrollment ID: O20040202000975 |
|---|
| Entity Name | Genesee Health System |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1043554348 PECOS PAC ID: 6002051091 Enrollment ID: O20130321000586 |
|---|
| Entity Name | Trauma and Addiction Solutions, PLLC |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1174381974 PECOS PAC ID: 3577903913 Enrollment ID: O20240501003889 |
|---|
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 |
Reviews and Comments