Jae Lee Ross, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025249 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-2000

NPI assigned

Jun 27, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Sloan Kettering Cancer Center at Basking Ridge New JerseyGroup PAC ID 0143229534, 230 clinicians

Memorial Psychiatry GroupGroup PAC ID 2062301476, 50 clinicians

MSK MonmouthGroup PAC ID 1153619291, 300 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.57 of 100Reported as group

Quality

72.31

Improvement activities

40

Cost

76.55

Merit-based Incentive Payment System (MIPS)

Final score

82.85 of 100Reported as group

Quality

80.94

Improvement activities

40

Cost

65.19

Merit-based Incentive Payment System (MIPS)

Final score

73.61 of 100Reported as group

Quality

70.88

Improvement activities

40

Cost

46.27

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Psychiatry Group

  • Psychiatry Physician
  • New York, NY
  • NPI 1689645244

  Clinical

  Medicare reassignment Care Compare group NPD
• Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey

  • Medical Oncology Physician
  • Basking Ridge, NJ
  • NPI 1184637886
  Medicare reassignment Care Compare group NPD
• MSK Monmouth

  • Medical Oncology Physician
  • Middletown, NJ
  • NPI 1922459163
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1063708188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706",
            "telephone_number": "646-227-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JAE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00701400",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37386",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Ross, M.D.
• Hannah Elizabeth Ross, LM, RN
• Heidi M Ross
• Helena B. Ross, LCSW
• Ivana Ross, MFT
• Jeffrey Adam Ross, M.D.
• Jerry Ross, CASAC 2
• Jessica Stuart Ross
• Joshua Ross, PT, DPT
• Joshua Ross, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.