JENNIFER L WILSON PH.D.
NPI 1124684600
Psychologist in Eden Prairie, MN

Active since May 10, 2019PECOS EnrolledAccepts Medicare Assignment
11010 PRAIRIE LAKES DR STE 350, EDEN PRAIRIE, MN 55344(952) 746-2522 Get Directions Write a Review

NPPES record last updated: May 10, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jennifer L Wilson Ph.d. NPPES

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

JENNIFER L WILSON PH.D. (NPI 1124684600) is an individual psychologist in Eden Prairie, Minnesota, licensed in Minnesota (LP5857) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1124684600
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJENNIFER L WILSONCredential: PH.D.
Location Address11010 PRAIRIE LAKES DR STE 350Eden Prairie, MN 55344-3801
Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 628-9566
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMay 10, 2019
✔ NPI 1124684600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MN · LP5857
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
11010 PRAIRIE LAKES DR STE 350, Eden Prairie, MN 55344

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer L Wilson Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092048025
PECOS Enrollment IDI20190606001956
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jennifer Wilson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Clinical
1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112
  • Reassigned Medicare billing, Minnesota enrollment
  • 794 clinicians in this Medicare group
Mental Health (Including Community Mental Health Center)
760 STILLWATER RD STE 101
Mahtomedi, MN 55115
  • Reassigned Medicare billing, Minnesota enrollment
  • 8 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Marriage & Family Therapist
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Marriage & Family Therapist
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344
Counselor (Addiction (Substance Use Disorder))
11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE, MN 55344

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 Wilson's NPI number?

The NPI number for Jennifer Wilson is 1124684600. It was assigned to this individual provider in the NPPES registry on May 10, 2019.

Where is Jennifer Wilson located?

Jennifer Wilson practices at 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344. The listed phone number is (952) 746-2522.

What is Jennifer Wilson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jennifer Wilson enrolled in Medicare?

Yes. Jennifer Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jennifer Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Wilson reassigns Medicare benefits to 2 organizations: Nystrom & Associates, Ltd (New Brighton, MN) and Jessica Dresden Psyd LP LLC (Mahtomedi, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Wilson accept?

Health plans from HealthPartners list Jennifer Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Wilson was last updated on May 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.