DR. JESSICA POLSON PSY.D.
NPI 1295103216
Psychologist - Clinical in Saint Louis, MO

Q: What is Jessica Polson's NPI number?

The NPI number for Jessica Polson is 1295103216. It was assigned to this individual provider in the NPPES registry on September 8, 2015.

Q: What is Jessica Polson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Polson was last updated on October 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since September 08, 2015PECOS Enrolled

1129 MACKLIND AVE, SAINT LOUIS, MO 63110(314) 534-0200(314) 534-7996 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Dr. Jessica Polson Psy.d. NPPES

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

DR. JESSICA POLSON PSY.D. (NPI 1295103216) is an individual clinical provider in Saint Louis, Missouri, licensed in Missouri (2020010031) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chesterfield.

NPPES Registry Identity

NPI1295103216

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JESSICA POLSONCredential: PSY.D.

Location Address1129 MACKLIND AVESaint Louis, MO 63110-1440

Mailing Address1129 Macklind AveSaint Louis, MO 63110-1440 · (314) 534-0200

Phone(314) 534-0200

Fax(314) 534-7996

Sole ProprietorNo

Enumeration DateSeptember 8, 2015

Last NPPES UpdateOctober 27, 2020

NPPES CertifiedOctober 27, 2020

✔ NPI 1295103216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MO · 2020010031

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedBehavior AnalystTaxonomy 103K00000X

1129 MACKLIND AVE, Saint Louis, MO 63110

Open in Google Maps ↗

Secondary Practice Location 1

Location 116216 Baxter Rd Ste 205Chesterfield, MO 63017-4778 · Phone (636) 532-9188 ext. 121 · Fax (636) 532-9951

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jessica Polson Psy.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Jessica Polson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. Louis Behavioral Medicine Institute Inc

Same address

Psychologist

1129 MACKLIND AVE
Saint Louis, MO 63110

Reassigned Medicare billing, Missouri enrollment
82 clinicians in this Medicare group

NPI 1487732335 (314) 534-0200

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63110 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

$169.38 typical visit price

range $55.65 – $169.38

Typical copayment $42.34 (range $13.91 – $42.34)

Most-billed visit code 99205

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

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 20

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

JESSICA LYN BURICH PMHNP

Nurse Practitioner (Psychiatric/Mental Health)