NPIMap

Individual provider Active NPI

Samantha Guyette, PA

  • Physician Assistant
  • South Portland, ME
National Provider Identifier
1245895879
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2090 Issued in ME
Practice address
119 Gannett Dr
South Portland, ME 04106-6942
Phone
(207) 773-0040
NPI assigned
May 9, 2019
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2090 ME Primary
Surgical Physician Assistant 363AS0400X NU
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

119 Gannett Dr
South Portland, ME 04106-6942

Mailing address

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 773-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021001680 ME Practitioner - Physician Assistant 8921428442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 773-0040

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

265 Western Ave
1 MMP Dermatology
South Portland, ME 04106-6942
Phone (207) 661-0100

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2090MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 30, 2023 Accepting new patients
Mainegeneral Medical Center Physician Assistant CurrentSince Sep 14, 2020 Accepting new patients
Maine Medical Partners Surgical CurrentSince Oct 30, 2023 Accepting new patients
Maine Medical Partners CurrentSince Oct 30, 2023 Accepting new patients
Mainehealth CurrentSince Oct 30, 2023 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 14, 2020 Accepting new patients
Mainehealth Past Accepting new patients

Locations

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

119 Gannett Dr
South Portland, ME 04106
Phone (207) 773-0040

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: sguyette639898@direct.mmc.mainehealth.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1245895879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066942",
            "telephone_number": "207-773-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066942",
            "telephone_number": "207-773-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUYETTE",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2090",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.