Jessica Marie Podpeskar, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

23768 Issued in MN

Practice address

615 Pecan Ave
Duluth, MN 55811-2749

Phone

(218) 355-2100

NPI assigned

Oct 12, 2021

Last updated

Oct 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jessica Podpeskar

  • Clinical Social Worker
  • Hermantown, MN
  • NPI 1780428805
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1245992742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PECAN AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112749",
            "telephone_number": "218-355-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODPESKAR",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "23768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bryan Plude, PSYD, LP
• Diedre K Plude, MA, LP
• Shelley Renee Plude, L.I.C.S.W.
• Walter E Plude, MSED, LP
• Nikki Plys
• Christopher Pogliano
• Richard Phillip Poirier
• Amanda Jean Pokorny, RPH, PHARMD
• Polinsky Medical Rehabilitation Center (Essentia Health Polinsky Medical Rehabilitation Center)
• Mallory Polivka, M.A., R-DMT

• Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.