Individual provider Active NPI

Kimberly Ann Heroux, MD

  • Obstetrics & Gynecology Physician
  • Jupiter, FL
National Provider Identifier
1124026497
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME96455 Issued in FL
Practice address
4495 Military TRL
#101
Jupiter, FL 33458-4839
Phone
(561) 799-3722
Fax
(561) 799-3692
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME96455 FL Primary

Addresses

Primary practice location

4495 Military TRL
#101
Jupiter, FL 33458-4839

Mailing address

1395 S State Road 7
#450
Wellington, FL 33414-9325
Phone (561) 798-1233

Other identifiers 1

IdentifierTypeStateIssuer
276148300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KIMBERLY.HEROUX@hca4.eclinicaldirectplus.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070721000051 FL Practitioner - Obstetrics/Gynecology 0648371500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Virginia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Women's Health and Body LLCGroup PAC ID 2264752443, 49 clinicians

Practice addresses (Care Compare)

1713 Hwy 441 N
Suite F
Okeechobee, FL 34972-1900
Phone (863) 763-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME96455FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Women's Health and Body, LLC Obstetrics & Gynecology CurrentSince Mar 1, 2015 Accepting new patients
Raulerson GYN LLC Past Accepting new patients

Locations

8188 S Jog Rd
Ste 203
Boynton Beach, FL 33472
Phone (561) 740-1191

4495 Military Trl
Ste 101
Jupiter, FL 33458
Phone (561) 799-3722

1395 S State Road 7
Ste 450
Wellington, FL 33414
Phone (561) 798-1233

560 Village Blvd
Ste 315
West Palm Beach, FL 33409
Phone (561) 616-9988

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1124026497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 S STATE ROAD 7",
            "address_2": "#450",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149325",
            "telephone_number": "561-798-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 MILITARY TRL",
            "address_2": "#101",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584839",
            "telephone_number": "561-799-3722",
            "fax_number": "561-799-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROUX",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME96455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276148300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KIMBERLY.HEROUX@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4495 Military Trl",
            "address_2": "#101",
            "city": "Jupiter",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334584839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.