SEAN STACK (M.D.) – Vascular & Interventional Radiology Physician, NPI 1962453217
Vascular & Interventional Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
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Provider Addresses for SEAN STACK (M.D.)
2925, Ryan Drive Southeast, Salem, Marion County, Oregon, 97301, United States
SALEM, OR 973019687
Phone: (503) 399-1264
Fax: (503) 371-0777
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $1,608.
Total Amount is formed as General ($1,608) + Research ($0) + Ownership ($0) = $1,608.
Last reported payment date: 2024-10-18 • Largest payer in this snapshot: Stryker Corporation ($728).
Total Amount
$1,608
General + Research + Ownership
Payments
20
Total payment records
General Amount
$1,608
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $728 |
| Penumbra, Inc. | $287 |
| Terumo Medical Corporation | $270 |
| Cook Medical LLC | $176 |
| Inari Medical, Inc. | $114 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040528001105 | I | Diagnostic Radiology | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71046 | X-ray of chest, 2 views | 206 | 205 | $0 |
| 71045 | X-ray of chest, 1 view | 156 | 140 | $0 |
| 70450 | Ct scan head or brain without contrast | 95 | 93 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 80 | 78 | $0 |
| 77063 | Screening 3d breast mammography | 58 | 58 | $0 |
Insurance plans in this area (ZIP 97301)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OR | 71250 | CT scan chest | 26 | 26 |
| DIAGNOSTIC RADIOLOGY | OR | 73630 | X-ray of foot, minimum of 3 views | 19 | 19 |
| DIAGNOSTIC RADIOLOGY | OR | 74177 | CT scan of abdomen and pelvis with contrast | 52 | 52 |
| DIAGNOSTIC RADIOLOGY | OR | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 11 | 11 |
| DIAGNOSTIC RADIOLOGY | OR | 77012 | Radiological supervision and interpretation of CT guidance for needle insertion | 22 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OR | |
| Diagnostic Radiology | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OR | |
| - | OR | |
| Sports Medicine | OR | |
| Diagnostic Radiology | OR | |
| - | OR | |
| Physician Assistant | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR |
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