MIKIKO DEMURA MARZILLI MS LD
NPI 1205373578
Dietitian, Registered in Bangor, ME

Active since January 25, 2017Accepts Medicare Assignment
905 UNION ST, SUITE 11, BANGOR, ME 04401(207) 973-7364 Get Directions Write a Review

NPPES record last updated: January 25, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mikiko Demura Marzilli Ms Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKIKO DEMURA MARZILLI MS LD (NPI 1205373578) is an individual dietitian, registered in Bangor, Maine, licensed in Maine (TD1334) and active in the NPI registry since January 2017. She is affiliated with Northern Light Eastern Maine Medical Center and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205373578
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMIKIKO DEMURA MARZILLICredential: MS LD
Location Address905 UNION ST, SUITE 11Bangor, ME 04401-3050
Mailing Address43 Whiting Hill Rd, Ste 300Brewer, ME 04412-1005 · (207) 973-5035 · Fax (207) 973-5042
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJanuary 25, 2017
NPI 1205373578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License Licensed in ME · TD1334
Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

905 UNION ST, Bangor, ME 04401

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mikiko Demura Marzilli Ms Ld is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597023622
PECOS Enrollment IDI20171219003095

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northern Light Eastern Maine Medical Center

Acute Care Hospitals · Bangor, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200033
Location489 State StreetBangor, ME 04401 · Penobscot County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $53.26 – $162.77
Typical copayment $0.00 (range $13.31 – $40.69)
Most-billed visit code NA
Established Patient
$94.60 typical visit price
range $16.90 – $132.79
Typical copayment $23.65 (range $4.22 – $33.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dietitian, Registered
905 UNION ST, SUITE 11
BANGOR, ME 04401
Dietitian, Registered
905 UNION ST, SUITE 11
BANGOR, ME 04401
Dietitian, Registered
905 UNION ST, SUITE 11
BANGOR, ME 04401
Dietitian, Registered
905 UNION ST, SUITE 11
BANGOR, ME 04401
Registered Nurse (Diabetes Educator)
905 UNION ST, SUITE 11
BANGOR, ME 04401
Registered Nurse (Diabetes Educator)
905 UNION ST, SUITE 11
BANGOR, ME 04401
Dietitian, Registered
905 UNION ST, 11
BANGOR, ME 04401
Clinical Neuropsychologist
905 UNION ST, SUITE 9
BANGOR, ME 04401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205373578, enumerated as an "individual" on January 25, 2017.

The provider is located at 905 UNION ST SUITE 11 BANGOR, ME 04401 and the phone number is (207) 973-7364.

Dietitian, Registered with taxonomy code 133V00000X.

Mikiko Marzilli is affiliated with: NORTHERN LIGHT EASTERN MAINE MEDICAL CENTER.