Individual provider Active NPI

Harsha Meghana Chekuri, PA-C

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1194587899
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
417 State St Ste 121
Bangor, ME 04401-6630
Phone
(207) 973-4266
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

417 State St Ste 121
Bangor, ME 04401-6630

Mailing address

43 Whiting Hill Rd
Brewer, ME 04412-1005
Phone (207) 973-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515001802 ME Practitioner - Physician Assistant 2466893953

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

43 Whiting Hill Rd
Suite 250
Brewer, ME 04412-1018

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jun 9, 2024 Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

417 State St
Ste 121
Bangor, ME 04401
Phone (207) 947-0147

489 State St
Ste A
Bangor, ME 04401

489 State St
Bangor, ME 04401
Phone (207) 973-8837

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1194587899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 121",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-973-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEKURI",
        "first_name": "HARSHA",
        "middle_name": "MEGHANA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.