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

Matthew A Stack, PAC

Individual provider Psychologist · NPI 1033108667

Matthew A Stack, PAC is a Physician Assistant in Ithaca, Michigan. Qualified in 2002, 24 years ago. Practices with Genesee Health System, a 37-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Michigan.

Years since qualifying
24
Licensed in
AZ, MI
In the registry since
2005
Specialties on file
4
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

121 N Pine River St
Ithaca, MI 48847-1039
Phone: (989) 287-0662
Show map & directions

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

Additional practice locations (1)

  • 1040 W Bristol Rd, Flint, MI 48507-5516 — (810) 257-3705

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601003961 (MI)
Psychologist Taxonomy 103T00000X · Licence 6301007939 (MI)
Medical Physician Assistant Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X · Licence 2782 (AZ)

Record details

NPI number1033108667
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 17, 2005
Last updated in NPPESFebruary 5, 2026
Certification dateFebruary 5, 2026
Mailing address121 N Pine River St, Ithaca, MI 48847-1039

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 Genesee Health System — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare