Karen Heroux, LCSW - Medicare Clinical Social Worker in Portland, ME

Karen Heroux, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Portland, Maine. She graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Sweetser and her current practice location is 1321 Washington Ave, Suite 106, Portland, Maine. You can reach out to her office (for appointments etc.) via phone at (888) 806-8801.

Karen Heroux is licensed to practice in Maine (license number LC6631) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1497831358.

Contact Information

Karen Heroux, LCSW
1321 Washington Ave, Suite 106,
Portland, ME 04103-3636
(888) 806-8801
(888) 806-8801

Map and Direction




Healthcare Provider's Profile

Full NameKaren Heroux
GenderFemale
SpecialityClinical Social Worker
Experience27 Years
Location1321 Washington Ave, Portland, Maine
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Karen Heroux graduated from medical school in 1997
  NPI Data:
  • NPI Number: 1497831358
  • Provider Enumeration Date: 10/31/2006
  • Last Update Date: 09/07/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 5193734267
  • Enrollment ID: I20060418000488

Medical Identifiers

Medical identifiers for Karen Heroux such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1497831358NPI-NPPES
432148799MedicaidME

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical LC6631 (Maine)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Sweetser8325946213105

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Karen Heroux allows following entities to bill medicare on her behalf.
Entity NameSweetser
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538122445
PECOS PAC ID: 8325946213
Enrollment ID: O20031230000339

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Karen Heroux is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Karen Heroux, LCSW
Po Box 7043,
Scarborough, ME 04070-7043

Ph: (888) 806-8801
Karen Heroux, LCSW
1321 Washington Ave, Suite 106,
Portland, ME 04103-3636

Ph: (888) 806-8801

Reviews and Comments


Social Worker in Portland, ME

Jeffrey Blake, LCSW
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.