Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kellie Ann P Goudreau, MS, PA-C

Individual provider Emergency Medicine Physician · NPI 1235410515

Kellie Ann P Goudreau, MS, PA-C is a Physician Assistant in Portland, Maine. Qualified in 2011, 15 years ago. Practices with Mainehealth, a 2,615-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maine and New Mexico.

Years since qualifying
15
Licensed in
ME, NM
In the registry since
2011
Specialties on file
3
What do these letters mean?
MS — Master of Science
A graduate science degree.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

144 State St
Portland, ME 04101-3776
Phone: (207) 879-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 25a June St, Sanford, ME 04073-2642 — (207) 490-3203
  • 1090 Goat Springs Road, Taos, NM 87571 — (575) 758-6917

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence PA1775 (ME)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA2012-0052 (NM)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA1775 (ME)

Record details

NPI number1235410515
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , PA-C
Sole proprietorNo
NPI enumeratedAugust 31, 2011
Last updated in NPPESDecember 5, 2024
Certification dateDecember 5, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Mainehealth — 2615 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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