Active NPI
Jacob Zimmerman Gross
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1609493360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 26 Court St Ste 1001
Brooklyn, NY 11242-1110 - Phone
- (732) 331-2968
- NPI assigned
- Jun 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NY | Primary |
Addresses
Primary practice location
26 Court St Ste 1001
Brooklyn, NY 11242-1110
Mailing address
454 Prospect PL Apt 2
Brooklyn, NY 11238-4149
Phone (732) 331-2968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2025 through Nov 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012256 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1609493360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 PROSPECT PL APT 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112384149",
"telephone_number": "732-331-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 COURT ST STE 1001",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112421110",
"telephone_number": "732-331-2968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "JACOB",
"middle_name": "ZIMMERMAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-29",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.