Individual provider Active NPI

Anthony Stewart Stack II, DO

  • Internal Medicine Physician
  • Safety Harbor, FL
National Provider Identifier
1528562832
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
UO5932 Issued in FL
Practice address
1840 Mease Dr Ste 409
Safety Harbor, FL 34695-6606
Phone
(727) 443-8450
Fax
(727) 533-5911
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO5932 FL
Internal Medicine Physician 207R00000X UO5932 FL Primary

Addresses

Primary practice location

1840 Mease Dr Ste 409
Safety Harbor, FL 34695-6606

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-7496

Other practice location 1

653-1 W 8th St # L18
Jacksonville, FL 32209-6511
Phone (904) 383-1003

Other identifiers 1

IdentifierTypeStateIssuer
UO5932OtherFLFLORIDA TRAINING LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Anthony.StackDO@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821004937 FL Practitioner - Hematology/Oncology 5496006298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

1840 Mease Dr
Safety Harbor, FL 34695-6606

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 461-8231

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO5932FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients
Baycare Medical Group, Inc. CurrentSince Aug 14, 2024 Accepting new patients
Baycare Medical Group, Inc CurrentSince Aug 14, 2024 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

1840 Mease Dr
Ste 409
Safety Harbor, FL 34695
Phone (727) 443-8450

Interoperability endpoints

  • Direct secure messaging: anthony.stackdo@direct.mybaycare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1528562832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MEASE DR STE 409",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956606",
            "telephone_number": "727-443-8450",
            "fax_number": "727-533-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653-1 W 8th St # L18",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-383-1003",
            "fax_number": "904-244-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "ANTHONY",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO5932",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO5932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA TRAINING LICENSE",
            "identifier": "UO5932",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Anthony.StackDO@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1840 Mease Dr Ste 409",
            "city": "Safety Harbor",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346956606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.