Individual provider Active NPI

Laurie Martens, PAC

  • Physician Assistant
  • South Portland, ME
National Provider Identifier
1215906904
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA52 Issued in ME
Practice address
100 Foden Rd E
Ste 203
South Portland, ME 04106-2327
Phone
(207) 874-1489
Fax
(207) 523-8590
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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 PA52 ME Primary

Addresses

Primary practice location

100 Foden Rd E
Ste 203
South Portland, ME 04106-2327

Mailing address

100 Gannett Drive
Ste C
South Portland, ME 04106
Phone (207) 347-2947

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
I20070824000663 ME Practitioner - Physician Assistant 2365534088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermed PAGroup PAC ID 5092605261, 185 clinicians

Practice addresses (Care Compare)

100 Foden Rd
South Portland, ME 04106-2327
Phone (207) 874-1489

100 Foden Rd W
Suite 100
South Portland, ME 04106-2327
Phone (207) 523-3900

100 Gannett Dr
Suite C
South Portland, ME 04106-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA52MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermed, PA CurrentSince Aug 24, 1998 Accepting new patients
Intermed, PA CurrentSince Aug 24, 1998 Accepting new patients

Locations

100 Foden Rd
Ste W-203
South Portland, ME 04106
Phone (207) 523-3900

100 Gannett Dr
Ste C
South Portland, ME 04106
Phone (207) 523-3649

100 Foden Rd
South Portland, ME 04106
Phone (207) 828-1122

100 Foden Rd
Ste W-100
South Portland, ME 04106
Phone (207) 523-3900

100 Foden Rd
Ste 203
South Portland, ME 04106
Phone (207) 874-1489

100 Foden Rd
Ste 100
South Portland, ME 04106
Phone (207) 874-1489

Interoperability endpoints

  • Direct secure messaging: laurie.martens@int.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1215906904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DRIVE",
            "address_2": "STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-347-2947",
            "fax_number": "207-874-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FODEN RD E",
            "address_2": "STE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062327",
            "telephone_number": "207-874-1489",
            "fax_number": "207-523-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "LAURIE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA52",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.