Ian Stack, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

103480 Issued in NC

Practice address

35 Memorial Dr
Pinehurst, NC 28374-8708

Phone

(910) 715-7856

NPI assigned

Feb 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, LA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson Davis Emergency Group LLCGroup PAC ID 2365496775, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner St Mary Hospital, Morgan City, LA, CCN 190014

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as group

Quality

81.54

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Jefferson Davis Emergency Group LLC

  • Emergency Medicine Physician
  • Jennings, LA
  • NPI 1043289572

  Medical

  Medicare reassignment Care Compare group NPD
• Hoke Emergency Group, PC

  • Emergency Medicine Physician
  • Raeford, NC
  • NPI 1003337528
  Medicare reassignment
• Sandhills Emergency Physicians PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pinehurst, NC
  • NPI 1003853409
  Medicare reassignment
• St Mary Emergency Group LLC

  • Emergency Medicine Physician
  • Morgan City, LA
  • NPI 1235108499
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ochsner Morgan City LLC

  • General Acute Care Hospital
  • Morgan City, LA
  • NPI 1205482023
  Care Compare affiliation

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1154590529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 JAMES CREEK RD",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283876819",
            "telephone_number": "910-692-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748708",
            "telephone_number": "910-715-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "IAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speech Connections, LLC
• Spencer L Smith DMD PLLC
• Lauren Spera, M.S. BCBA LBS
• Thomas Spiegel, PA
• Rhonda Sue Spivey, CFM
• Bernard Marion Stanfield, M.D.
• Cathy Frazier Stanley, RDMS
• Meredith Murphy Stanton, M.D.
• Ellen B Starnes, LCSW.LCAS
• Robert Clayton Steiner, M.D.

• Medical Physician Assistant in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.