Samuel Stack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1042 Issued in NH

Practice address

104 Meadow St
Littleton, NH 03561-4026

Phone

(603) 444-2592

NPI assigned

Jun 16, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Envision Eye Care, PLLCGroup PAC ID 1951437136, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Envision Eye Care, PLLC

  dba Littleton Eye Care Center

  • Optometrist
  • Littleton, NH
  • NPI 1184953937
  Medicare reassignment Care Compare group NPD
• William S Holmes, OD

  dba Littleton Eye Care Center

  • Optometrist
  • Littleton, NH
  • NPI 1346364197
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1114542149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MEADOW ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035614026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MEADOW ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035614026",
            "telephone_number": "603-444-2592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 E 38th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165041559",
            "country_code": "US",
            "telephone_number": "814-860-2789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003662",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Space to Breathe, PLLC
• Spencer Drug Store
• Tracie B Spencer, LCMHC
• John Henry Spicer, MD
• Claudette Claire St Laurent
• Robb D. Stander, WAIVER
• Richard Alfred Stewart II
• Robert Stone, CRNA
• Kasey Lauren Strand, DMD
• Kevin Michael Stratton, OD

• Optometrist in Littleton, NH
• Providers in Littleton, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.