Mary Jean Stark, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA003135L Issued in PA

Practice address

9 Nathan LN
Annville, PA 17003-6500

Phone

(717) 639-3350

Fax

(717) 303-3546

NPI assigned

Mar 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstark61819@wellspan.direct-ci.com

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.

• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment Care Compare group
• Lebanon Internal Medicine Associates, P.C.

  • Internal Medicine Physician
  • Lebanon, PA
  • NPI 1700878261
  Medicare reassignment NPD
• The Good Samaritan Hospital of Lebanon, Pennsylvania

  • Emergency Medicine Physician
  • Lebanon, PA
  • NPI 1730754284
  Medicare reassignment NPD
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Langhorne, PA
  • NPI 1114955010
  Medicare reassignment
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Wilkes Barre, PA
  • NPI 1235374927

  Physician Assistant

  NPD
• Lebanon Internal Medicine Associates PC

  • Clinical Medical Laboratory
  • Lebanon, PA
  • NPI 1417009291
  NPD
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  • Family Medicine Physician
  • Christiana, PA
  • NPI 1427509942
  NPD
• Lebanon Emergency Physicians PC

  • Specialist
  • Lebanon, PA
  • NPI 1508907262
  NPD (past)

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

• The Good Samaritan Hospital of Lebanon, Pennsylvania

  • Ambulatory Surgical Clinic/Center
  • Lebanon, PA
  • NPI 1205902343

  Hospital

  Care Compare affiliation
• The Good Samaritan Hospital of Lebanon, Pennsylvania

  • General Acute Care Hospital
  • Lebanon, PA
  • NPI 1407928500
  Care Compare affiliation
• The Good Samaritan Hospital of Lebanon, Pennsylvania

  • Emergency Medicine Physician
  • Lebanon, PA
  • NPI 1730754284

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1851352884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NATHAN LN",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "170036500",
            "telephone_number": "717-639-3350",
            "fax_number": "717-303-3546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Lititz",
            "state": "PA",
            "postal_code": "175439274",
            "country_code": "US",
            "telephone_number": "717-466-2445",
            "fax_number": "717-466-2447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "446 N Reading Rd",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175229802",
            "country_code": "US",
            "telephone_number": "717-738-5275",
            "fax_number": "717-738-5278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003135L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03246701",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00791043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Smith
• Brian M Spar, M.D.
• Sirae Richelle Sprecher, LCSW
• Melissa T Stapinski, MD
• James E. Stark, ATC
• Chardae Stone
• Megan Streisel, M.ED., LAT
• Alexis Erin Stroman, CRNP
• Synergy Health Group PC
• Helen Marie Traglia, B.S. C.M.T.

• Physician Assistant in Annville, PA
• Providers in Annville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.