MATTHEW A STACK PA C
NPI 1033108667
Physician Assistant in Ithaca, MI

Active since October 17, 2005PECOS EnrolledAccepts Medicare Assignment
121 N PINE RIVER ST, ITHACA, MI 48847(989) 287-0662 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2026, May 10, 2024, Sep 21, 2016 and 1 more (4 updates tracked since 2016).

About Matthew A Stack Pa C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW A STACK PA C (NPI 1033108667) is an individual physician assistant in Ithaca, Michigan, licensed in Michigan (5601003961) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Flint, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1033108667
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMATTHEW A STACKCredential: PA C
Location Address121 N PINE RIVER STIthaca, MI 48847-1039
Mailing Address121 N Pine River StIthaca, MI 48847-1039 · (989) 287-0662 · Fax (989) 629-8145
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateOctober 17, 2005
Last NPPES UpdateFebruary 5, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2026
NPI 1033108667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses Licensed in MI · 5601003961 Licensed in AZ · 2782
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPsychologistTaxonomy 103T00000X · License 6301007939 (MI)
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
121 N PINE RIVER ST, Ithaca, MI 48847

Secondary Practice Location 1

Location 11040 W Bristol RdFlint, MI 48507-5516 · Phone (810) 257-3705 · Fax (989) 629-8145

Other Identifiers 4

OtherP00140431AZ · Railroad
Other0852900260MI · Bcbsm
Medicaid762246AZ
Other50155318NM · Medicaid

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Matthew A Stack Pa C is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981896685
PECOS Enrollment IDI20101013000935
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48847 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
121 N PINE RIVER ST
ITHACA, MI 48847
Clinic/Center (Mental Health (Including Community Mental Health Center))
121 N PINE RIVER ST
ITHACA, MI 48847
Clinic/Center (Rural Health)
121 N PINE RIVER ST
ITHACA, MI 48847
Counselor (Professional)
121 N PINE RIVER ST
ITHACA, MI 48847
Clinic/Center (Rural Health)
121 N PINE RIVER ST
ITHACA, MI 48847
Family Medicine
121 N PINE RIVER ST
ITHACA, MI 48847
Nurse Practitioner (Family)
121 N PINE RIVER ST
ITHACA, MI 48847

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Stack's NPI number?

The NPI number for Matthew Stack is 1033108667. It was assigned to this individual provider in the NPPES registry on October 17, 2005.

Where is Matthew Stack located?

Matthew Stack practices at 121 N Pine River St, Ithaca, MI 48847. The listed phone number is (989) 287-0662.

What is Matthew Stack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Matthew Stack enrolled in Medicare?

Yes. Matthew Stack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Matthew Stack accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Matthew Stack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Stack was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.