DR. JARED S SPENCER – Clinical Psychologist, NPI 1477199636

DR. JARED S SPENCER is a healthcare provider. based in Oak brook, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. LP6688 (MN). The NPI Number for DR. JARED S SPENCER is 1477199636

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. JARED S SPENCER
NPI
1477199636
Phone
(630) 571-5750
Address
1200 HARGER RD STE 600
Enumeration Date
22 November 2019
Last Update Date
7 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524434600
Graduation Year
2018 (8 years ago)
PAC ID
7214335157
Group Practice PAC ID
7810282845
Professional Enrollment ID
I20211007001870
Address ID
MN553729228PR16180SEXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. JARED S SPENCER

  • 1200 HARGER RD STE 600

    OAK BROOK, IL 605231820

    Phone: (630) 571-5750

    Type: Mailing

  • PO BOX 51

    VICTORIA, MN 553860051

    Phone: (952) 443-4600

    Type: Mailing

  • 16180 HASTINGS AVE SE STE 205

    PRIOR LAKE, MN 553729228

    Phone: (952) 443-4600

    Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

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: 2021-10-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211007001870IClinical PsychologistMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60523)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810282845View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How do I look up DR. JARED S SPENCER by NPI?
Use NPI 1477199636 when you need to reference DR. JARED S SPENCER in forms, claims, or directories.
Is DR. JARED S SPENCER currently active in the NPI registry?
CMS-published data lists DR. JARED S SPENCER as an active registrant.
Does DR. JARED S SPENCER list a primary specialty?
If you are matching referrals, note Clinical Psychologist for DR. JARED S SPENCER. Clinical services aligned with this taxonomy classification.
Where does public data place DR. JARED S SPENCER?
The snapshot lists Oak Brook, Illinois for DR. JARED S SPENCER; download NPPES for the complete set.
Is DR. JARED S SPENCER a real provider?
This page reflects official NPPES data for NPI 1477199636. Always confirm identity and privileges with the practice and licensing boards.