Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Logan Joldersma

Individual provider Physician Assistant · NPI 1063034114

Logan Joldersma is a Physician Assistant in Portland, Maine. Qualified in 2020, 6 years ago. Accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
6
Licensed in
NM
In the registry since
2020

Practice location Address checks out

22 Bramhall St
Portland, ME 04102-3134
Phone: (207) 662-2381
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA2025-0056 (NM)

Record details

NPI number1063034114
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 12, 2020
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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