Raven Cross, in San Jose, CA - Medicare Nurse Practitioner

Raven Cross, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in San Jose, California. Her current practice location is 1165 Lincoln Ave Ste 150, San Jose, California. You can reach out to her office (for appointments etc.) via phone at (408) 372-8580.

Raven Cross is licensed to practice in California (license number 95019647) 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 1114596624.

Contact Information

	Raven Cross,
	1165 Lincoln Ave Ste 150, San Jose, CA 95125-3045
	(408) 372-8580
	Not Available

Map and Direction

Provider's Profile

Full Name	Raven Cross
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1165 Lincoln Ave Ste 150, San Jose, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114596624
Provider Enumeration Date: 06/18/2021
Last Update Date: 05/25/2023

Medicare PECOS Information:

PECOS PAC ID: 6800265257
Enrollment ID: I20221207002371

Medical Identifiers

Medical identifiers for Raven Cross such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114596624	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WP0807X	Registered Nurse - Psychiatric/mental Health, Child & Adolescent	95142217 (California)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	0024183375 (Virginia)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95019647 (California)	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. Raven Cross allows following entities to bill medicare on her behalf.

Entity Name	Grow Healthcare Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080

Entity Name	California Behavioral & Nursing Professionals Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528625209 PECOS PAC ID: 0547625287 Enrollment ID: O20230502000511

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. Raven Cross 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
Raven Cross, 1165 Lincoln Ave Ste 150, San Jose, CA 95125-3045 Ph: () -	Raven Cross, 1165 Lincoln Ave Ste 150, San Jose, CA 95125-3045 Ph: (408) 372-8580

Reviews and Comments

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Raven Cross, - Medicare Nurse Practitioner in San Jose, CA