Jennifer Marie Gross, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Mill Creek, Washington. Her current practice location is
15418 Main St, Mill Creek, Washington. You can reach out to her office (for appointments etc.) via phone at
(425) 339-5453.
Jennifer Marie Gross is licensed to practice in Washington (license number PY61194123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023197951.
Healthcare Provider's Profile
Full Name | Jennifer Marie Gross |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 15418 Main St, Mill Creek, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023197951
- Provider Enumeration Date: 11/02/2006
- Last Update Date: 06/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 8628469772
- Enrollment ID: I20230706002642
Medical Identifiers
Medical identifiers for Jennifer Marie Gross such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023197951 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 00005653 (Washington) | Secondary |
103TC0700X | Psychologist - Clinical | PY61194123 (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jennifer Marie Gross allows following entities to bill medicare on her behalf.
Entity Name | The Polyclinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174594634 PECOS PAC ID: 2163328196 Enrollment ID: O20031210000788 |
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Entity Name | Optum Care Washington Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1831186766 PECOS PAC ID: 6406752153 Enrollment ID: O20031211000922 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Marie Gross is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jennifer Marie Gross, PSYD Po Box 5127, Everett, WA 98206-5127 Ph: (425) 304-8431 | Jennifer Marie Gross, PSYD 15418 Main St, Mill Creek, WA 98012-9030 Ph: (425) 339-5453 |
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