Matthew Alexander Stack, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

BP10082502 Issued in TX

Practice address

6431 Fannin St # 2.112
Houston, TX 77030-1501

Phone

(713) 500-6765

Fax

(713) 500-5495

NPI assigned

May 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Infectious Disease

Education

Wayne State University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
• SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046

Merit-based Incentive Payment System (MIPS)

Final score

84.94 of 100Reported as group

Quality

68.52

Promoting interoperability

100

Improvement activities

40

Cost

72.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544

  Infectious Disease

  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• University of Texas

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1245567874
  NPD (past)

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

• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare affiliation
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1962994491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST # 2.112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6765",
            "fax_number": "713-500-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST # 2.112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6765",
            "fax_number": "713-500-5495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025209",
            "country_code": "US",
            "telephone_number": "317-278-2694",
            "fax_number": "317-278-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 S Spring Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102520",
            "country_code": "US",
            "telephone_number": "314-617-3137",
            "fax_number": "314-977-3127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "MATTHEW",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "BP10082502",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11020118A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles St.Martin, R.PH.
• Enrique Marquez Sta Ana V, MD
• Stacey Nicole Jones PA
• Stacey Wells MD PLLC
• Carol Blossom Stach, M.A.
• Madonna Stacker
• Kesa Stackhouse
• Eileen C Stade, M.D.
• Alexander N Stadnyk, M.D.
• Gregg A Staerkel, M.D.

• Infectious Disease Physician in Houston, TX
• Providers in Houston, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2024; 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.