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MS. JENNIFER A POLLEY MD
NPI 1114089026
Pediatrics in Centralia, WA

Active since December 15, 2006Opted out of Medicare · through Dec 31, 2027
1911 COOKS HILL RD., CENTRALIA, WA 98531(360) 736-6778(360) 736-6552 Get Directions Write a Review

NPPES record last updated: May 17, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Jennifer A Polley Md NPPES

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

MS. JENNIFER A POLLEY MD (NPI 1114089026) is an individual pediatrics provider in Centralia, Washington, licensed in Washington (MD00027525) and active in the NPI registry since December 2006. She has opted out of Medicare through December 31, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1114089026
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMS. JENNIFER A POLLEYCredential: MD
Location Address1911 COOKS HILL RD.Centralia, WA 98531
Mailing Address1911 Cooks Hill Rd.Centralia, WA 98531 · (360) 736-6778 · Fax (360) 736-6552
Phone(360) 736-6778
Fax(360) 736-6552
Sole ProprietorNo
Enumeration DateDecember 15, 2006
Last NPPES UpdateMay 17, 2010
✔ NPI 1114089026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WA · MD00027525
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1911 COOKS HILL RD., Centralia, WA 98531
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Other Identifiers 2

Medicare UPINF39506WA
Medicaid1058825WA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Jennifer A Polley Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 31, 2013 through December 31, 2027.

Opt-Out Effective DateDecember 31, 2013
Opt-Out In Effect ThroughDecember 31, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98531 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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

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

MR. JAMES M MILLER MD
Pediatrics
1911 COOKS HILL RD.
CENTRALIA, WA 98531
Lewis County (360) 736-6778

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 Jennifer Polley's NPI number?

The NPI number for Jennifer Polley is 1114089026. It was assigned to this individual provider in the NPPES registry on December 15, 2006.

Where is Jennifer Polley located?

Jennifer Polley practices at 1911 Cooks Hill Rd., Centralia, WA 98531. The listed phone number is (360) 736-6778.

What is Jennifer Polley's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jennifer Polley enrolled in Medicare?

No. Jennifer Polley has opted out of Medicare through December 31, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jennifer Polley was last updated on May 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.