Macular Renewal Center PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

MACULAR RENEWAL CENTER PLLC

Practice address

5300 Gateway Ctr Ste B
Flint, MI 48507-3930

Phone

(810) 410-7383

Fax

(810) 720-9098

NPI assigned

Nov 12, 2025

Last updated

Apr 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Patrick Stack, MDNPI 1801899885

Title

Owner

Phone

(810) 410-7383

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward P Stack, M.D.

  • Ophthalmology Physician
  • Flint, MI
  • NPI 1801899885
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1407716574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 GATEWAY CTR STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073930",
            "telephone_number": "810-410-3001",
            "fax_number": "810-720-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 GATEWAY CTR STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073930",
            "telephone_number": "810-410-7383",
            "fax_number": "810-720-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACULAR RENEWAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-410-7383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lyn Mack
• Tihesa Mack, LMSW,ACSW
• Amy M Mackie, NURSE PRACTITIONER
• Niketa Macklin
• Michael J Macksood, D.O.
• Jim Madany, D.D.S.
• Leo Maranon Madarang, MD
• Daniel Thomas Madaras
• Carl H Maddox, CCAR
• Fnu Madhumithaa Jagannathan, M.D.

• Ophthalmology Physician in Flint, MI
• Providers in Flint, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.