Individual provider Active NPI

Shifra Leah Gross, PSY.D.

  • Psychologist
  • Jupiter, FL
National Provider Identifier
1265247514
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY12380 Issued in FL
Practice address
210 Jupiter Lakes Blvd Ste 201
Jupiter, FL 33458-7188
Phone
(561) 870-0411
Fax
(561) 972-4036
NPI assigned
Feb 12, 2025
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY12380 FL Primary

Addresses

Primary practice location

210 Jupiter Lakes Blvd Ste 201
Jupiter, FL 33458-7188

Mailing address

210 Jupiter Lakes Blvd Ste 201
Jupiter, FL 33458-7188
Phone (561) 870-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY12380FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1265247514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD STE 201",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587188",
            "telephone_number": "561-870-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD STE 201",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587188",
            "telephone_number": "561-870-0411",
            "fax_number": "561-972-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "SHIFRA",
        "middle_name": "LEAH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY12380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.