DR. JIE JIAO (PH.D.) – Clinical Psychologist, NPI 1053720284
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for DR. JIE JIAO (PH.D.)
8600 N STATE ROUTE 91
SUITE 240
PEORIA, IL 616159541
Phone: (309) 683-5094
Type: Mailing
2205 State St
Pekin, IL 615543936
Phone: (888) 428-7890
Fax: (877) 428-7891
Type: Location
5901 N PROSPECT RD STE 202
PEORIA, IL 616144358
Phone: (888) 428-7890
Fax: (877) 428-7891
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-10-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141030001566 | I | Clinical Psychologist | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | 18 | 18 | $0 |
| 96130 | Evaluation of psychological test, first hour | 15 | 15 | $0 |
| 96136 | Administration of psychological or neuropsychological test, first 30 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 61615)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | IL | |
| Mental Health Counselor | IL | |
| Mental Health Counselor | IL | |
| Nurse Practitioner | IL | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | IL | |
| Clinical Social Worker | NM | |
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL | |
| Clinical Social Worker | IL |
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