Individual provider Active NPI

Samuel Harcourt, PA-S

  • Surgical Physician Assistant
  • Augusta, ME
National Provider Identifier
1619772555
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2976 Issued in ME
Practice address
15 Enterprise Dr Ste 100
Augusta, ME 04330-7998
Phone
(207) 621-8700
NPI assigned
Feb 14, 2025
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2976 ME Primary

Addresses

Primary practice location

15 Enterprise Dr Ste 100
Augusta, ME 04330-7998

Mailing address

16 Forest Ave
Cumberland, ME 04021-3008
Phone (512) 748-6052

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
I20260219003283 ME Practitioner - Physician Assistant 9133600943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of 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)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2976MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Mar 1, 2026 Accepting new patients
Mainegeneral Medical Center CurrentSince Mar 1, 2026 Accepting new patients

Locations

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

15 Enterprise Dr
Ste 100
Augusta, ME 04330
Phone (207) 621-7500

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1619772555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FOREST AVE",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040213008",
            "telephone_number": "512-748-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR STE 100",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307998",
            "telephone_number": "207-621-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARCOURT",
        "first_name": "SAMUEL",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA2976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.