Individual provider Active NPI

Heather Lynne Demark

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1568165264
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2732 Issued in ME
Practice address
417 State St Ste 340
Bangor, ME 04401-6634
Phone
(207) 973-4949
Fax
(207) 973-4466
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 PA2732 ME Primary

Addresses

Primary practice location

417 State St Ste 340
Bangor, ME 04401-6634

Mailing address

27 State St Ste 52
Bangor, ME 04401-5113
Phone (651) 728-2991

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
I20240905001295 ME Practitioner - Physician Assistant 9436699451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Suite 330
Bangor, ME 04401-6638
Phone (207) 973-8881

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2732MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Sep 29, 2024 Accepting new patients
MRH Corp. Past Accepting new patients

Locations

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

417 State St
Ste 340
Bangor, ME 04401
Phone (207) 973-4949

Organizations & group practices 3

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 3

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": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1568165264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 STATE ST STE 52",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015113",
            "telephone_number": "651-728-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 340",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016634",
            "telephone_number": "207-973-4949",
            "fax_number": "207-973-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARK",
        "first_name": "HEATHER",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.