JENNIFER MARIE GROSS (PSYD) – Clinical Psychologist, NPI 1023197951
Clinical Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JENNIFER MARIE GROSS (PSYD)
805 164TH ST SE STE 101
MILL CREEK, WA 980126316
Phone: (206) 300-6644
Type: Mailing
1902 120TH PL SE STE 102B
EVERETT, WA 982088400
Phone: (206) 300-6644
Type: Mailing
805 164th St SE Ste 101
Mill Creek, WA 980126316
Phone: (206) 300-6644
Type: Location
PO BOX 5127
EVERETT, WA 982065127
Phone: (425) 304-8431
Type: Mailing
15418 MAIN ST
MILL CREEK, WA 980129030
Phone: (425) 339-5453
Fax: (425) 252-4441
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.
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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: 2023-07-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230706002642 | I | Psychiatry | WA | TBD |
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.
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 98012)
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