Matthew T. Stark, PA-C.
NPI 1174700934ActiveIndividual· Physician Assistant, Medical· Roseburg, OR
Physician Assistant, Medical (PA-C.) with Centennial Medical Group East LLC and 1 other group, practicing in Roseburg, Oregon. Their prescriptions cost Medicare Part D more than their services did: $463,784 for 4,088 claims, against $1,429 paid for services in 2024. Lists Mercy Medical Center as a hospital affiliation.
Overview
| NPI | 1174700934 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C. |
| Sole proprietor | No |
| NPI issued | Jan 23, 2008 |
| Last updated in NPPES | Jun 11, 2020 |
| Certified by provider | Jun 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | OR |
| Physician Assistant, Medical | 363AM0700X | — | — |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 35 |
|---|---|
| Services billed | 49 across 14 procedure codes |
| Paid by Medicare | $1,429 |
Part D prescriptions in 2024
| Prescriptions (claims) | 4,088 · 8,837 30-day fills |
|---|---|
| Patients | 370 |
| Total drug cost | $463,784 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Centennial Medical Group East LLCRoseburg, OR · 65 clinicians
- Evergreen Family Medicine PCRoseburg, OR · 54 clinicians
Hospital affiliation
- Mercy Medical CenterRoseburg, OR
Other facilities
- Amedisys Home Health CareHome health agency · Roseburg, OR
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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