Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ian Stack, PA

Individual provider Medical Physician Assistant · NPI 1154590529

Ian Stack, PA is a Physician Assistant in Pinehurst, North Carolina. Qualified in 2002, 24 years ago. Practices with Jefferson Davis Emergency Group LLC, an 18-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
24
Licensed in
NC
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

35 Memorial Dr
Pinehurst, NC 28374-8708 Not confirmed with CMS for 18 years — call before visiting
Phone: (910) 715-7856
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 103480 (NC)

Record details

NPI number1154590529
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 29, 2008
Last updated in NPPESFebruary 29, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Jefferson Davis Emergency Group Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients80
Services billed 110 a service is one billed item, such as a visit, a test or a procedure
Average patient age67

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Ochsner St Mary Hospital · Morgan City, LA

Colleagues at Jefferson Davis Emergency Group LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 18 clinicians in the practice; 6 are shown here.

Other providers in Pinehurst