Individual provider Active NPI

Apollo Alexander Stack, MD

  • Pain Medicine (Anesthesiology) Physician
  • Omaha, NE
National Provider Identifier
1962993261
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
34887 Issued in NE
Practice address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone
(402) 609-3000
Fax
(402) 609-3808
NPI assigned
May 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 8200 NE
Pain Medicine (Anesthesiology) Physician 207LP2900X MD-52095 IA
Pain Medicine (Anesthesiology) Physician 207LP2900X 34887 NE Primary

Addresses

Primary practice location

2725 S 144TH St Ste 212
Omaha, NE 68144-5253

Mailing address

2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 609-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230812000066 NE Practitioner - Pain ManagementPractitioner - Anesthesiology 3678827839 Reassigns benefits to 1 organization
I20231006000783 IA Practitioner - Pain ManagementPractitioner - Anesthesiology 3678827839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Nebraska College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthowest, LLCGroup PAC ID 8921086893, 109 clinicians

Practice addresses (Care Compare)

1260 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (402) 609-3000

2725 S 144TH St
Suite 212
Omaha, NE 68144-5253
Phone (402) 609-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest LLC Pain Medicine CurrentSince Aug 1, 2023 Accepting new patients
Orthowest LLC Anesthesiology CurrentSince Aug 1, 2023 Accepting new patients

Locations

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000

17701 Manderson St
Omaha, NE 68116

7100 W Center Rd
Ste 200
Omaha, NE 68106

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 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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1962993261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "APOLLO",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "8200",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IA",
            "license": "MD-52095",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NE",
            "license": "34887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.