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JASMINE KYLA POLKOWSKE MD
NPI 1124887617
Radiology - Diagnostic Radiology in Charleston, SC

Active since March 18, 2024PECOS Enrolled
169 ASHLEY AVENUE, CHARLESTON, SC 29425(843) 792-1767 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jasmine Kyla Polkowske Md NPPES

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

JASMINE KYLA POLKOWSKE MD (NPI 1124887617) is an individual diagnostic radiology provider in Charleston, South Carolina, licensed in South Carolina (MMD.95051) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124887617
Entity TypeIndividualFemale
Primary Taxonomy2085R0202X
Provider Legal NameJASMINE KYLA POLKOWSKECredential: MD
Location Address169 ASHLEY AVENUECharleston, SC 29425
Mailing Address96 Jonathan Lucas, Msc 323Charleston, SC 29425-3230 · (843) 792-7179
Phone(843) 792-1767
Sole ProprietorNo
Enumeration DateMarch 18, 2024
Last NPPES UpdateJune 30, 2025
NPPES CertifiedJune 30, 2025
✔ NPI 1124887617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in SC · MMD.95051
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
169 ASHLEY AVENUE, Charleston, SC 29425
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jasmine Kyla Polkowske Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
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 20

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

DR. JAMES HOWARD BENSON III MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-4074
COURTNEY AUGUSTA LUKITSCH MD
Psychiatry & Neurology (Psychiatry)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-9162
DR. CHARLES SPENCER TEIXEIRA DO
Internal Medicine (Infectious Disease)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC 333
CHARLESTON, SC 29425
Charleston County (843) 792-2575
CHELSEA WRIGHT-VOID MD
Pathology (Anatomic Pathology & Clinical Pathology)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-1086
HELEN JENSIE BURTON MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-2911
DR. MITCHELL BENTON MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-5386
DR. ALLISON CRECELIUS DO
Emergency Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (314) 808-5444
RONIT KULKARNI
Surgery
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-2081

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 Jasmine Polkowske's NPI number?

The NPI number for Jasmine Polkowske is 1124887617. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Jasmine Polkowske located?

Jasmine Polkowske practices at 169 Ashley Avenue, Charleston, SC 29425. The listed phone number is (843) 792-1767.

What is Jasmine Polkowske's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Jasmine Polkowske enrolled in Medicare?

Yes. Jasmine Polkowske is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jasmine Polkowske was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.