Individual provider Active NPI

Jennifer L Harvey, PAC

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1629074075
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA702 Issued in ME
Practice address
992 Union St
Bangor, ME 04401-3057
Phone
(207) 992-2601
Fax
(207) 404-8351
NPI assigned
Jun 21, 2005
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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 PA702 ME Primary

Addresses

Primary practice location

992 Union St
Bangor, ME 04401-3057

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247

Other identifiers 1

IdentifierTypeStateIssuer
305890099MedicaidME

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
I20070215000242 ME Practitioner - Physician Assistant 5597767822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maine Medical Consultants PCGroup PAC ID 7810229259, 46 clinicians
Pai Participant 7 PCGroup PAC ID 2466788906, 31 clinicians

Practice addresses (Care Compare)

335 Brighton Ave
Portland, ME 04102-2363
Phone (207) 518-8869

367 US Route 1
Suite 3S
Falmouth, ME 04105-1352
Phone (207) 962-1200

44 Hogan Rd
Bangor, ME 04401-5602
Phone (207) 942-2333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA702MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 7 PC CurrentSince Nov 1, 2025 Accepting new patients
Independent Medical Associates, PA Past Accepting new patients
Penobscot Community Health Center PastSince May 9, 2021 Accepting new patients
Penobscot Community Health Center PastSince May 9, 2021 Accepting new patients

Locations

367 US Route 1
Ste 3S
Falmouth, ME 04105
Phone (207) 939-6789

Organizations & group practices 5

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

Hospital & facility affiliations 2

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1629074075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013057",
            "telephone_number": "207-992-2601",
            "fax_number": "207-404-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305890099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.