MATTHEW A STACK PA C
NPI 1033108667
Psychologist in Ithaca,


Quality Rating: 100 out of 100 score

NPI Status: Active since October 17, 2005

Contact Information

121 N Pine River St
Ithaca,
Post Code: 48847
Phone: (989) 287-0662
Fax: (989) 629-8145

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Matthew A Stack Pa C in Ithaca - Psychologist

Matthew A Stack Pa C is a Psychologist in Ithaca, . Matthew A Stack Pa C practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Matthew A Stack Pa C is 1033108667. The last update date is 2024-05-10.

Matthew A Stack Pa C's current location address is 121 N Pine River St, Ithaca, . You can contact this provider via phone number (989) 287-0662 and fax number (989) 629-8145. The mailing address for Matthew A Stack Pa C is 121 N Pine River St, Ithaca, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1033108667
Provider Name
MATTHEW A STACK PA C
Gender
Male
Entity Type
Individual
Location Address
121 N Pine River St, Ithaca,
Location Phone
(989) 287-0662
Location Fax
(989) 629-8145
Mailing Address
121 N Pine River St, Ithaca, Michigan(MI)
Mailing Phone
989-287-0662
Mailing Fax
-
Enumeration Date
2005-10-17
Last Update Date
2024-05-10
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
-
License No.
5601003961
License State
Michigan (MI)
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 103T00000X Psychologist

Psychologist

6301007939 (Michigan)
2 363A00000X Physician Assistant

Physician Assistant

2782 (Arizona)
3 363AM0700X Medical Physician Assistant

Physician Assistant, Medical

()

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0852900260 Other (non-Medicare) (01) Michigan (MI) BCBSM
50155318 Other (non-Medicare) (01) New Mexico (NM) Medicaid
762246 MEDICAID (05) Arizona (AZ)
P00140431 Other (non-Medicare) (01) Arizona (AZ) Railroad

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033108667
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20632016612
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 20632016612
2 + 0 + 6 + 3 + 2 + 0 + 1 + 6 + 6 + 1 + 2 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 7 7

The NPI number 1033108667 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003819004 MARY BERNONA STEVENS
Individual
Dentist, General Practice 1172 NIXON AVE NW
GRAND RAPIDS, Michigan (MI)
616-453-0644
1003819897 ANTHONY A EMMER
Individual
Psychiatry & Neurology, Neurology 26400 W 12 MILE RD
SOUTHFIELD, Michigan (MI)
248-208-8787
1023011871 ELIZABETH SCHMITT
Individual
Radiology, Diagnostic Radiology 36561 HARPER AVE
CLINTON TWP, Michigan (MI)
586-791-0620
1003819970 ROGER W. THOMPSON
Individual
Dentist, General Practice 201 N RIVERSIDE AVE
ST CLAIR, Michigan (MI)
810-329-2289
1003819400 GLENN E MERZ
Individual
Family Medicine 1675 LEAHY ST
MUSKEGON, Michigan (MI)
231-728-5007