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

Mr. Jack Marshall Stark, PA-C

Individual provider Medical Physician Assistant · NPI 1669436820

Mr. Jack Marshall Stark, PA-C is a Physician Assistant in Danbury, Connecticut. Qualified in 1987, 39 years ago. Practices with Prohealth Physicians PC, a 212-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.

Years since qualifying
39
Licensed in
CT
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

100 Reserve Rd Ste A4
Danbury, CT 06810-5267
Phone: (203) 794-1979
Fax: (203) 794-1796
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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 000044 (CT)

Record details

NPI number1669436820
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 14, 2006
Last updated in NPPESOctober 20, 2022
Certification dateOctober 20, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Prohealth Physicians Pc — 212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Danbury