MARY JEAN STARK (PAC) – Physician Assistant, NPI 1851352884
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,691 PHYSICIAN ASSISTANT in PA
Provider Addresses for MARY JEAN STARK (PAC)
252 S 4th St
Lebanon, PA 170426111
Phone: (717) 270-7688
Fax: (717) 270-3790
Type: Location
446 N Reading Rd
Ephrata, PA 175229802
Phone: (717) 738-5275
Fax: (717) 738-5278
Type: Location
101 W Airport Rd
Lititz, PA 175439274
Phone: (717) 466-2445
Fax: (717) 466-2447
Type: Location
3421 CONCORD RD
YORK, PA 174029001
Phone: (717) 639-3350
Fax: (717) 303-3546
Type: Mailing
9 NATHAN LN
ANNVILLE, PA 170036500
Phone: (717) 639-3350
Fax: (717) 303-3546
Type: Location
601 MEMORY LN
YORK, PA 174022231
Phone: (717) 851-1405
Fax: (717) 851-6969
Type: Mailing
Norman Drive, Hauckville, North Cornwall Township, Lebanon County, Pennsylvania, 17042, United States
LEBANON, PA 170427497
Phone: (717) 273-6706
Fax: (717) 273-1435
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050613000482 | I | Physician Assistant | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 17042)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | PA | |
| - | PA | |
| - | PA | |
| N E U R O L O G Y | SC | |
| Physician Assistant | PA | |
| Hospitalist, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | PA | |
| Physician Assistant | PA | |
| Family Practice | PA | |
| Internal Medicine, Pulmonary Disease, Sleep Medicine | PA |
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