NPIMap

Individual provider Active NPI

Marie A Pedersen, LCSW

  • Clinical Social Worker
  • Windham, ME
National Provider Identifier
1033234224
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC5501 Issued in ME
Practice address
584 Roosevelt TRL
Windham, ME 04062-7302
Phone
(207) 662-8907
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC5501 ME Primary

Addresses

Primary practice location

584 Roosevelt TRL
Windham, ME 04062-7302

Mailing address

584 Roosevelt TRL
Windham, ME 04062-7302
Phone (207) 662-8907

Other names 1

  • Marie A Bennett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000531 ME Practitioner - Clinical Social Worker 8022049766 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

111 Ossipee TRL E
Suite 1153
Standish, ME 04084-6421
Phone (207) 661-4850

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 3, 2023 Accepting new patients
Mainehealth CurrentSince Jul 3, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jun 7, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jun 7, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jun 7, 2021 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1033234224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040627302",
            "telephone_number": "207-662-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040627302",
            "telephone_number": "207-662-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "MARIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "BENNETT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Windham, ME

Sources for this page

Verify at the official NPI Registry.