Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samuel Gagnon, PA-C

Individual provider Physician Assistant · NPI 1407121932

Samuel Gagnon, PA-C is a Physician Assistant in South Portland, Maine. Qualified in 2011, 15 years ago. Practices with Mainehealth, a 2,615-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maine.

Years since qualifying
15
Licensed in
ME
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

265 Western Ave Ste 2
South Portland, ME 04106-2458
Phone: (207) 661-0200
Fax: (207) 661-0299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA1456 (ME)

Record details

NPI number1407121932
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 16, 2012
Last updated in NPPESJune 14, 2021
Certification dateFebruary 1, 2021

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
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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