NPIMap

Individual provider Active NPI

Jason Travis Stack, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Vero Beach, FL
National Provider Identifier
1164869699
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
ME135652 Issued in FL
Practice address
3955 Indian River Blvd Ste 100
Vero Beach, FL 32960-4800
Phone
(772) 569-2330
Fax
(772) 569-2632
NPI assigned
May 23, 2013
Last updated
Aug 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME135652 FL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X ME135652 FL Primary

Addresses

Primary practice location

3955 Indian River Blvd Ste 100
Vero Beach, FL 32960-4800

Mailing address

3955 Indian River Blvd Ste 100
Vero Beach, FL 32960-4800
Phone (772) 569-2330

Other practice location 1

1222 S Orange Ave
5th Floor MP 43
Orlando, FL 32806-1215
Phone (321) 841-1764

Other practice location 2

801 Wellness Way Ste 100
Sebastian, FL 32958-3783
Phone (772) 509-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180727002647 FL Practitioner - Orthopedic Surgery 7911145701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vero Orthopaedics II PAGroup PAC ID 2567454051, 48 clinicians

Practice addresses (Care Compare)

801 Wellness Way
Suite 100
Sebastian, FL 32958-3783
Phone (772) 388-9510

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.95 of 100Reported as group
Quality
82.89
Promoting interoperability
98
Improvement activities
40
Cost
71.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement94
Knee replacement176
Lower limb (leg) arthroscopy (minimally invasive joint repair)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME135652FLMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vero Orthopaedics II PA Orthopaedic Surgery CurrentSince Aug 12, 2019 Accepting new patients
Vero Orthopaedics II PA Orthopaedic Surgery CurrentSince Aug 12, 2019 Accepting new patients

Locations

801 Wellness Way
Ste 100
Sebastian, FL 32958
Phone (772) 388-9510

1155 35th Ln
Ste 100
Vero Beach, FL 32960
Phone (772) 569-2330

3955 Indian River Blvd
Ste 100
Vero Beach, FL 32960
Phone (772) 569-2330

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jason.stack.p1@direct.veroortho.nextgenshare.com

Organizations & group practices 2

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

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1164869699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 INDIAN RIVER BLVD STE 100",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604800",
            "telephone_number": "772-569-2330",
            "fax_number": "772-569-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 INDIAN RIVER BLVD STE 100",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604800",
            "telephone_number": "772-569-2330",
            "fax_number": "772-569-2632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 S Orange Ave",
            "address_2": "5th Floor MP 43",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061215",
            "country_code": "US",
            "telephone_number": "321-841-1764",
            "fax_number": "321-843-6992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Wellness Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583783",
            "country_code": "US",
            "telephone_number": "772-509-2330",
            "fax_number": "772-569-2630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "JASON",
        "middle_name": "TRAVIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2021-08-08",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME135652",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME135652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.