1. Home
  2. Directory
  3. Maine
  4. Bangor
  5. Nurse Practitioner
  6. NPI Profile

JASON MICHAEL FONSECA ACNPC-AG
NPI 1881589596
Nurse Practitioner - Acute Care in Bangor, ME

Active since June 11, 2025PECOS EnrolledAccepts Medicare Assignment
360 BROADWAY, BANGOR, ME 04401(207) 907-1000 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jason Michael Fonseca Acnpc-ag NPPES

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

JASON MICHAEL FONSECA ACNPC-AG (NPI 1881589596) is an individual acute care provider in Bangor, Maine, licensed in Maine (CNP251067) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS, is affiliated with St Joseph Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1881589596
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameJASON MICHAEL FONSECACredential: ACNPC-AG
Location Address360 BROADWAYBangor, ME 04401-3979
Mailing Address23 Riverview RdHampden, ME 04444-1727 · (207) 949-3070
Phone(207) 907-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 11, 2025
NPPES CertifiedMay 28, 2025
✔ NPI 1881589596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in ME · CNP251067
360 BROADWAY, Bangor, ME 04401
Open in Google Maps ↗

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

Jason Michael Fonseca Acnpc-ag 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 ID3274046206
PECOS Enrollment IDI20250702000312
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

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

St Joseph Hospital

Acute Care Hospitals · Bangor, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number200001
Location360 BroadwayBangor, ME 04401 · Penobscot County
Emergency services

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
$82.58 typical visit price
range $53.26 – $162.77
Typical copayment $20.64 (range $13.31 – $40.69)
Most-billed visit code 99203
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.

JAMES HILDEBRAND M.D.
Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-1703
THERESA ANNE YOUNG RN
Registered Nurse
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 525-4526
DANE HASSANI MD
Anesthesiology
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-1430
LIGA YUSVIRAZI MD
Emergency Medicine
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-3283
DR. PEDRO PABLO GOMEZ VALENCIA M.D.
Surgery
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-3650
DR. ALGIS VYDAS M.D.
Specialist
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 262-1938
DR. GANESHA SANTHYADKA MD
Internal Medicine (Pulmonary Disease)
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-1155
DR. AMINA S QAZI DO, PHARMD
Internal Medicine (Cardiovascular Disease)
360 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 907-1770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Fonseca's NPI number?

The NPI number for Jason Fonseca is 1881589596. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Jason Fonseca located?

Jason Fonseca practices at 360 Broadway, Bangor, ME 04401. The listed phone number is (207) 907-1000.

What is Jason Fonseca's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Jason Fonseca enrolled in Medicare?

Yes. Jason Fonseca is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jason Fonseca affiliated with any hospitals?

According to CMS data, Jason Fonseca is affiliated with St Joseph Hospital and Northern Light Eastern Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Jason Fonseca was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.