JESSE TAO BUEDEFELDT-POLLARD M.D.
NPI 1669768644
Obstetrics & Gynecology - Obstetrics in Springfield, IL

Q: What is Jesse Buedefeldt-pollard's NPI number?

The NPI number for Jesse Buedefeldt-pollard is 1669768644. It was assigned to this individual provider in the NPPES registry on June 28, 2011. The provider is also known as Jesse Tao Pollard.

Q: What is Jesse Buedefeldt-pollard's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Obstetrics, with taxonomy code 207VX0000X.

Active since June 28, 2011PECOS EnrolledAccepts Medicare Assignment

421 N 9TH ST BLDG Q, SPRINGFIELD, IL 62702(217) 545-8000 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 20, 2025, Oct 20, 2020, Nov 8, 2016 and 2 more (5 updates tracked since 2016).

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About Jesse Tao Buedefeldt-pollard M.d. NPPES

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

JESSE TAO BUEDEFELDT-POLLARD M.D. (NPI 1669768644) is an individual obstetrics provider in Springfield, Illinois, licensed in Illinois (036140756) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1669768644

Entity TypeIndividualMale

Primary Taxonomy207VX0000X

Provider Legal NameJESSE TAO BUEDEFELDT-POLLARDCredential: M.D.

Location Address421 N 9TH ST BLDG QSpringfield, IL 62702-5317

Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000 · Fax (844) 470-2486

Phone(217) 545-8000

Sole ProprietorNo

Medical School CMSAlbany Medical College Of Union UniversityGraduated 2011

Enumeration DateJune 28, 2011

Last NPPES UpdateNovember 20, 20255 updates tracked since enumeration

NPPES CertifiedNovember 20, 2025

✔ NPI 1669768644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · ObstetricsAllopathic & Osteopathic Physicians

Taxonomy Code207VX0000X

License✔ Licensed in IL · 036140756

Definition

A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License MD171594 (OR)

421 N 9TH ST BLDG Q, Springfield, IL 62702

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Other Names 1

Former Name (1)Jesse Tao Pollard

Secondary Practice Location 1

Location 1415 N 9th St, Suite 6W100Springfield, IL 62702-5303 · Phone (217) 545-8000 · Fax (217) 545-4912

Other Identifiers 1

Medicaid036140756IL

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

Jesse Tao Buedefeldt-pollard M.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 ID2062651953

PECOS Enrollment IDI20161019001420

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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140148

Location701 N First StSpringfield, IL 62702 · Sangamon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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 5

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

SRAAVYA SAI UNDURTY AKELLA MD

Obstetrics & Gynecology