Individual provider Active NPI

Samantha Danielle Smith, CST

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1588443204
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
716 Stevens Ave
Portland, ME 04103-2656
Phone
(207) 797-7261
NPI assigned
Sep 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

716 Stevens Ave
Portland, ME 04103-2656

Mailing address

19 Lucia Way
Kennebunkport, ME 04046-7785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728002060 ME Practitioner - Physician Assistant 0446767198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New England, College of Osteo Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901
Phone (207) 872-1000

15 Enterprise Dr
Mainegeneral Express Care
Augusta, ME 04330-7997
Phone (207) 621-8880

211 Main St
Waterville, ME 04901-6117
Phone (207) 877-3400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center Physician Assistant CurrentSince Aug 11, 2025 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 11, 2025 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: samanthasmith@mgh.allscriptsdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1588443204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LUCIA WAY",
            "city": "KENNEBUNKPORT",
            "state": "ME",
            "postal_code": "040467785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032656",
            "telephone_number": "207-797-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMANTHA",
        "middle_name": "DANIELLE",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.