MICHAEL T. STACK MD PHD – NPI #1770585945
Internal Medicine

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases.

MICHAEL STACK is a physician located in INDIANAPOLIS, IN. NPPES has assigned the NPI number 1770585945 to MICHAEL STACK on June 01, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RR0500X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Rheumatology

The NPI profile was previously updated about 4 years ago on Jan 06, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MICHAEL STACK below.

NPI Profile for
MICHAEL T. STACK

NPI Number
1770585945
Enumeration Date

(more than 21 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MICHAEL T. STACK
Credentials
MD PHD
Primary location
6447 S EAST ST STE A
INDIANAPOLIS, IN 46227-2119
Phone: (317) 859-6364 Fax: (317) 859-7537
1 Other location(s):
2845 Greenbrier Rd
Green Bay, WI 54311
Phone: (920) 288-8100
Fax: (920) 288-8153
Mailing address
6551 FORREST COMMONS BLVD
INDIANAPOLIS, IN 46227-2392
Phone: Fax:
Sole Proprietor
No
Updated
Certification Date
Jan 06, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MICHAEL STACK

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSS BLUE SHIELDIN000000318888
OTHEROFFICE/GROUP NPI1265457774
MEDICAIDIN100133510B
MEDICAIDWI100083069
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RR0500X
- Internal Medicine / Rheumatology (Primary)
IN 01026374
1744R1102X
- Specialist / Research Study
IN 01026374

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.