Individual provider Active NPI

Kyle M St. John, PA-C

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1942413877
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2989 Issued in ME
Practice address
33 Sewall St
Portland, ME 04102-2638
Phone
(207) 828-2100
Fax
(207) 553-7166
NPI assigned
May 7, 2007
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2989 ME Primary
Physician Assistant 363A00000X PA15865 CA

Addresses

Primary practice location

33 Sewall St
Portland, ME 04102-2638

Mailing address

33 Sewall St
Portland, ME 04102-2638
Phone (207) 828-2100

Other practice location 1

14 Thomas Point Rd
Brunswick, ME 04011-3911
Phone (207) 828-2100

Other practice location 2

4 Commons Ave Ste A
Windham, ME 04062-5554
Phone (207) 828-2100

Other practice location 3

22 Station Ave Ste 201
Brunswick, ME 04011-2092
Phone (207) 828-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150731016123 CA Practitioner - Physician Assistant 6204140494 Reassigns benefits to 1 organization
I20260210003831 ME Practitioner - Physician Assistant 6204140494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2101

730 Ctr St
Auburn, ME 04210-6316
Phone (207) 783-3450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15865CAMDClinical Psychologist
PA15865CAMDPhysician Assistant
PA2989MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Maine PA CurrentSince Feb 2, 2026 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Jun 1, 2015 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Jun 1, 2015 Accepting new patients
American Current Care, P.a. CurrentSince Feb 2, 2026 Accepting new patients
American Current Care P.a. CurrentSince Feb 2, 2026 Accepting new patients
Orthopaedic Associates of Maine PA CurrentSince Feb 2, 2026 Accepting new patients
Orthopaedic Associates of Maine PA Past Accepting new patients

Locations

4445 Eastgate Mall
Ste 103
San Diego, CA 92121
Phone (858) 450-7118

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

4910 Directors Pl
Ste 350
San Diego, CA 92121
Phone (858) 346-7171

33 Sewall St
Portland, ME 04102
Phone (207) 772-0076

85 Western Ave
Ste 6
South Portland, ME 04106
Phone (207) 774-7751

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1942413877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022638",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022638",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Thomas Point Rd",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040113911",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Commons Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "ME",
            "postal_code": "040625554",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Station Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112092",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "KYLE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2989",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.