1. Home
  2. Directory
  3. Maine
  4. Portland
  5. Internal Medicine
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMUEL MATTHIAS PETTIT DO
NPI 1003556291
Internal Medicine - Geriatric Medicine in Portland, ME

Active since March 29, 2022PECOS Enrolled
66 BRAMHALL ST, PORTLAND, ME 04102(207) 662-3157(207) 662-6434 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Samuel Matthias Pettit Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL MATTHIAS PETTIT DO (NPI 1003556291) is an individual geriatric medicine provider in Portland, Maine, licensed in Maine (DO4340) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003556291
Entity TypeIndividualMale
Primary Taxonomy207RG0300X
Provider Legal NameSAMUEL MATTHIAS PETTITCredential: DO
Location Address66 BRAMHALL STPortland, ME 04102-3344
Mailing Address66 Bramhall StPortland, ME 04102-3344 · (207) 662-3157 · Fax (207) 662-6434
Phone(207) 662-3157
Fax(207) 662-6434
Sole ProprietorNo
Enumeration DateMarch 29, 2022
Last NPPES UpdateAugust 18, 2026
NPPES CertifiedAugust 18, 2026
✔ NPI 1003556291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in ME · DO4340
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedInternal MedicineTaxonomy 207R00000X · License DO4340 (ME)
66 BRAMHALL ST, Portland, ME 04102
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Matthias Pettit Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$169.96 typical visit price
range $56.28 – $169.96
Typical copayment $42.49 (range $14.07 – $42.49)
Most-billed visit code 99205
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTHA KOLAR IVES OTR/L
Occupational Therapist
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-4628
LEAH VICTORIA MAHONEY ANP
Nurse Practitioner (Adult Health)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-3157
SARAH A. M. HALLEN M.D.
Internal Medicine (Geriatric Medicine)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-3157
WILL PORTA LMSW-CC
Social Worker (Clinical)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2221
STACEY R FARRINGTON ANP
Nurse Practitioner (Adult Health)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-3157
CAITLIN GABRIELLE MCKENZIE APRN, FNP
Registered Nurse
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2847
VALERIE MELISSA BOISVERT LCSW
Social Worker (Clinical)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-3101
ANN K MAGNER DO
Internal Medicine (Geriatric Medicine)
66 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-3157

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Pettit's NPI number?

The NPI number for Samuel Pettit is 1003556291. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Where is Samuel Pettit located?

Samuel Pettit practices at 66 Bramhall St, Portland, ME 04102. The listed phone number is (207) 662-3157.

What is Samuel Pettit's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Samuel Pettit enrolled in Medicare?

Yes. Samuel Pettit is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Pettit was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.