Doctor profile · Federal record
Dr. Polly Peterson, PH.D.
School Psychologist (CMS: Clinical Psychologist) · Orange Park, FL
- NPI 1902929698
- Accepts Medicare
- 53 yrs in practice
- Female
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
1543 Kingsley Ave Ste 14
Orange Park, FL 320734570
(904) 742-8164
fax (904) 217-7222 - Mailing address
-
2465 US Highway 1 S Unit 154
St Augustine, FL 320866076
Credentials & registration
- NPI registered
- April 2007 — 19 yrs on file
- Profile last updated
- March 12, 2021
- Year of graduation
- 1973 — 53 yrs since
- Specialty taxonomy
- 103TS0200X — NUCC code
- State license (1)
- Florida #SS495
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1902929698. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
217
Distinct HCPCS
2
Medicare allowed
$12,810
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
90785 |
Psychiatric services complicated by communication factor | 130 | 16 | $13 | |
90837 |
Psychotherapy, 1 hour | 87 | 15 | $128 |
In context: peer comparison
Among 1 peers in this city , average services per provider: 108. This provider delivers 2.0× the peer median.Frequently asked questions
What is Dr. Polly Peterson's medical specialty?
Dr. Polly Peterson practices School Psychologist in Orange Park, FL.
Where does Dr. Polly Peterson practice?
Dr. Polly Peterson practices at 1543 Kingsley Ave Ste 14, Orange Park, FL 320734570. Office phone: 9047428164.
What is Dr. Polly Peterson's NPI?
Dr. Polly Peterson's National Provider Identifier (NPI) is 1902929698, issued by NPPES.
Does Dr. Polly Peterson accept Medicare assignment?
Yes. Dr. Polly Peterson accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Polly Peterson commonly perform?
Top Medicare-reported procedures in 2023: Psychiatric services complicated by communication factor (HCPCS 90785); Psychotherapy (HCPCS 90837). Source: CMS Medicare Physician & Other Practitioners file.