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

Kelsey Marie Stack, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1033344049

Kelsey Marie Stack, DO is an Emergency Medicine in Syracuse, New York. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2009, 17 years ago. Practices with Upstate Emergency Medicine, Inc, a 54-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
17
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
NY
In the registry since
2009
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

750 E Adams St
Syracuse, NY 13210-2342
Phone: (315) 464-5136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 262832 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1033344049
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 19, 2009
Last updated in NPPESAugust 31, 2012
Mailing address2850 Lafayette Rd, La Fayette, NY 13084-9529

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2009 (17 years in practice)
Group practice Upstate Emergency Medicine, Inc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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