DR. STEPHEN P OLSEN (M.D.) – Anatomic Pathology & Clinical Pathology Physician, NPI 1164862629

DR. STEPHEN P OLSEN (M.D.) is a healthcare provider. based in Saint louis, Missouri. specializing in PATHOLOGY. They hold the professional credentials M.D.. They hold a License No. 2013108517 (MO). The NPI Number for DR. STEPHEN P OLSEN (M.D.) is 1164862629

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. STEPHEN P OLSEN (M.D.)
NPI
1164862629
Phone
(314) 747-3000
Address
4921 Parkview Pl
Enumeration Date
28 June 2013
Last Update Date
27 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9103437000
Graduation Year
2013 (13 years ago)
PAC ID
6901153923
Group Practice PAC ID
2668369075
Professional Enrollment ID
I20180723002338
Address ID
NC284017407WI2131XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:12State licenses:2Digital endpointsOther names

406 PATHOLOGY in MO

Provider Addresses for DR. STEPHEN P OLSEN (M.D.)

  • 4921 Parkview Pl

    Saint Louis, MO 63110

    Phone: (314) 747-3000

    Type: Location

  • 1915 S 17TH ST STE 100

    WILMINGTON, NC 284016683

    Phone: (910) 362-9511

    Type: Mailing

  • 4921 PARKVIEW PL

    SAINT LOUIS, MO 63110

    Phone: (314) 747-3000

    Type: Location

  • PO BOX 20169

    ROANOKE, VA 240180506

    Phone: (540) 767-2700

    Fax: (540) 767-2708

    Type: Mailing

  • 2131 S 17TH ST

    WILMINGTON, NC 284017407

    Phone: (910) 343-7074

    Fax: (910) 343-7829

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2023-07-27 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$24
View all Open Payments →|Open Payments Risk Radar →

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: 2018-07-23

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
I20180723002338IPathologyNCTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88305Pathology examination of tissue using a microscope, intermediate complexity2,2551,409$0
88341Special stained specimen slides to examine tissue, each additional procedure1,094237$0
88342Special stained specimen slides to examine tissue, initial procedure473379$0
88360Microscopic genetic analysis of tumor, manual319113$0
88112Cell examination of specimen, selective cellular enhancement technique276233$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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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: 2668369075View full group profile
NameSpecialtyState
P A T H O L O G YNC
-VA
P A T H O L O G YTN
P A T H O L O G YNC
P A T H O L O G YPA
P A T H O L O G YVA
P A T H O L O G YVA
P A T H O L O G YVA
Pathology, HematologyVA

Reviews

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Frequently asked questions

How do I look up DR. STEPHEN P OLSEN (M.D.) by NPI?
Use NPI 1164862629 when you need to reference DR. STEPHEN P OLSEN (M.D.) in forms, claims, or directories.
Is DR. STEPHEN P OLSEN (M.D.)'s NPI currently valid?
The extract we use shows DR. STEPHEN P OLSEN (M.D.) as active.
Does DR. STEPHEN P OLSEN (M.D.) list a primary specialty?
If you are matching referrals, note Anatomic Pathology & Clinical Pathology Physician for DR. STEPHEN P OLSEN (M.D.). Clinical services aligned with this taxonomy classification.
Where does public data place DR. STEPHEN P OLSEN (M.D.)?
The snapshot lists Saint Louis, Missouri for DR. STEPHEN P OLSEN (M.D.); download NPPES for the complete set.
How can I contact DR. STEPHEN P OLSEN (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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