DR. JACQUELYN K. WIERSMA PH. D.
NPI 1386757300
Psychologist - Clinical in Minnetonka, MN

Active since August 16, 2006PECOS EnrolledAccepts Medicare Assignment
3931 AUBURN DR, MINNETONKA, MN 55305(952) 938-9499(952) 938-9499 Get Directions Write a Review

NPPES record last updated: February 3, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jacquelyn K. Wiersma Ph. D. NPPES

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

DR. JACQUELYN K. WIERSMA PH. D. (NPI 1386757300) is an individual clinical provider in Minnetonka, Minnesota, licensed in Minnesota (LP1583) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1979).

NPPES Registry Identity

NPI1386757300
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JACQUELYN K. WIERSMACredential: PH. D.
Location Address3931 AUBURN DRMinnetonka, MN 55305-5196
Mailing Address3931 Auburn DrMinnetonka, MN 55305-5196 · (952) 938-9499 · Fax (952) 938-9499
Fax(952) 938-9499
Sole ProprietorNo
Medical School CMSOtherGraduated 1979
Enumeration DateAugust 16, 2006
Last NPPES UpdateFebruary 3, 2017
NPI 1386757300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in MN · LP1583
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.

3931 AUBURN DR, Minnetonka, MN 55305

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacquelyn K. Wiersma 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 ID3173562519
PECOS Enrollment IDI20050426000891
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 55305 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
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

Psychologist (Clinical)
3931 AUBURN DR
MINNETONKA, MN 55305

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 Jacquelyn Wiersma's NPI number?

The NPI number for Jacquelyn Wiersma is 1386757300. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Where is Jacquelyn Wiersma located?

Jacquelyn Wiersma practices at 3931 Auburn Dr, Minnetonka, MN 55305. The listed phone number is (952) 938-9499.

What is Jacquelyn Wiersma's specialty?

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

Is Jacquelyn Wiersma enrolled in Medicare?

Yes. Jacquelyn Wiersma 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.

When was this NPI record last updated?

The NPPES record for Jacquelyn Wiersma was last updated on February 3, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.