Active NPI
Matthew Steven Stake, PA-C
- Physician Assistant
- Hanover, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- OA004494
- Practice address
- 250 Fame Ave Ste 206-a
Hanover, PA 17331-1587 - Phone
- (717) 316-2248
- NPI assigned
- Jul 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA059828 | PA | |
| Medical Physician Assistant | 363AM0700X | OA004494 | PA | |
| Physician Assistant | 363A00000X | OA004494 | PA | Primary |
| Physician Assistant | 363A00000X | MA059828 | PA |
Addresses
Primary practice location
250 Fame Ave Ste 206-a
Hanover, PA 17331-1587
Mailing address
16837 Roosevelt LN
Shrewsbury, PA 17361-1625
Phone (717) 576-5162
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103552557 | Medicaid | PA | |
| 727045 | Other | PA | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mstake89159@phsdirect.pinnaclehealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180913001643 | PA | Practitioner - Physician Assistant | 9133479058 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pinnacle Health Medical Services
Practice addresses (Care Compare)
111 S Front St
Harrisburg, PA 17101-2010
1701 Innovation Dr
York, PA 17408-8815
Phone (717) 843-8623
1703 Innovation Dr
York, PA 17408-8815
2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100
2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363
2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100
2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143
300 Highland Ave
Hanover, PA 17331-2297
Phone (717) 316-3711
361 Alexander Spring Rd
Carlisle, PA 17015-6940
Phone (717) 231-8508
805 Sir Thomas CT
Harrisburg, PA 17109-4839
Phone (717) 988-0020
810 Sir Thomas CT
Suite 101
Harrisburg, PA 17109-4839
Phone (717) 614-4420
815 Sir Thomas CT
Suite 200
Harrisburg, PA 17109-4839
Phone (717) 724-0720
820 Sir Thomas Court 2ND Floor
Pinnaclehealth Familycare Union Deposit
Harrisburg, PA 17109-4839
Phone (717) 657-3030
820 Sir Thomas CT
Harrisburg, PA 17109-4839
Phone (717) 652-9555
Hospital & facility affiliations
- Upmc Pinnacle Hospitals
- Upmc Hanover
- Upmc Memorial
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.08 of 100
- Quality
- 76.48
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.12
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA059828 | PA | MD | Medical Physician Assistant |
| OA004494 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Health Regional Physicians | Physician Assistant | Current | Accepting new patients |
| Pinnacle Health Medical Services | Current | Accepting new patients | |
| Pinnacle Health Regional Physicians | Current | Accepting new patients | |
| Pinnacle Health Medical Services | Current | Accepting new patients | |
| Hanover Health Corporation | Past | Accepting new patients | |
| Pinnacle Health Medical Services | Physician Assistant | Past | Accepting new patients |
Locations
210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300
366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900
250 Fame Ave
Ste 206A
Hanover, PA 17331
Phone (717) 316-2248
1404 Baltimore St
Ste 4
Hanover, PA 17331
Phone (717) 637-0470
2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100
Interoperability endpoints
- mstake304400@upmc.direct-ci.com
Organizations & group practices 11
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.
-
- Internal Medicine Physician
- Harrisburg, PA
- NPI 1013441690
PA, Physician Assistant
-
- Radiology Clinic/Center
- Hummelstown, PA
- NPI 1003490566
-
- Radiology Clinic/Center
- Camp Hill, PA
- NPI 1346905759
-
- Radiology Clinic/Center
- Hanover, PA
- NPI 1356977649
-
- Radiology Clinic/Center
- York, PA
- NPI 1598337206
-
- Gastroenterology Physician
- Mechanicsburg, PA
- NPI 1295552073
-
- Orthopaedic Surgery Physician
- Hershey, PA
- NPI 1679290688
-
- Family Medicine Physician
- Lancaster, PA
- NPI 1508386756
-
- Family Medicine Physician
- Hanover, PA
- NPI 1083950687
-
- Endocrinology, Diabetes & Metabolism Physician
- Mechanicsburg, PA
- NPI 1518918523
Physician Assistant
Hospital & facility affiliations 11
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": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1982190377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16837 ROOSEVELT LN",
"city": "SHREWSBURY",
"state": "PA",
"postal_code": "173611625",
"telephone_number": "717-576-5162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FAME AVE STE 206-A",
"city": "HANOVER",
"state": "PA",
"postal_code": "173311587",
"telephone_number": "717-316-2248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAKE",
"first_name": "MATTHEW",
"middle_name": "STEVEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-09",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA059828",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "OA004494",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "OA004494",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA059828",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103552557",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA",
"identifier": "727045",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mstake89159@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "250 Fame Ave Ste 206-A",
"city": "Hanover",
"state": "PA",
"country_code": "US",
"postal_code": "173311587",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hanover, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.