Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kathryn E Stack, MD

Individual provider Anesthesiology Physician · NPI 1326081969

Kathryn E Stack, MD is an Anesthesiology in Old Lyme, Connecticut. Graduated from New York Medical College in 1992, 34 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
34
Trained at
New York Medical College
Licensed in
CT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

15 Wood Crest Dr
Old Lyme, CT 06371-2840
Phone: (404) 932-9109
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 57186 (CT)

Record details

NPI number1326081969
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 13, 2006
Last updated in NPPESDecember 23, 2021
Certification dateDecember 23, 2021
Mailing address15 Wood Crest Dr, Old Lyme, CT 06371-2840

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 1992 (34 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount