Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy Polk, AA

Individual provider Anesthesiologist Assistant · NPI 1346699865

Jeremy Polk, AA is an Anesthesiology Assistant in Saint Louis, Missouri. Qualified in 2016, 10 years ago. Practices with South County Anesthesia Associates Ltd, a 81-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
10
Licensed in
MO
In the registry since
2016
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Practice location Address checks out

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone: (636) 386-3722
Fax: (636) 200-4036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 2016017707 (MO)

Record details

NPI number1346699865
Entity typeIndividual (Type 1)
GenderMale
Credentials AA
Sole proprietorNo
NPI enumeratedJune 6, 2016
Last updated in NPPESJune 6, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice South County Anesthesia Associates Ltd — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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