DR. JAE LEE ROSS PSY.D.
NPI 1063708188
Psychologist - Clinical in New York, NY
About Dr. Jae Lee Ross Psy.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JAE LEE ROSS PSY.D. (NPI 1063708188) is an individual clinical provider in New York, New York, licensed in New York (025249) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jae Lee Ross Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Jae Ross reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 69 clinicians in this Medicare group
Middletown, NJ 07748
- Reassigned Medicare billing, New Jersey enrollment
- 464 clinicians in this Medicare group
Basking Ridge, NJ 07920
- Reassigned Medicare billing, New Jersey enrollment
- 385 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10065
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jae Ross's NPI number?
The NPI number for Jae Ross is 1063708188. It was assigned to this individual provider in the NPPES registry on June 27, 2011.
Where is Jae Ross located?
Jae Ross practices at 1275 York Ave, New York, NY 10065. The listed phone number is (212) 639-2000.
What is Jae Ross's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jae Ross enrolled in Medicare?
Yes. Jae Ross is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jae Ross's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jae Ross reassigns Medicare benefits to 3 organizations: Memorial Psychiatry Group (New York, NY), Msk Monmouth (Middletown, NJ) and Memorial Sloan Kettering Cancer Center At Basking Ridge New Jersey (Basking Ridge, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jae Ross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jae Ross was last updated on August 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Jae Lee Ross, PSY.D. · NPI 1063708188
Clinical provider in New York, New York. Individual provider, active in the CMS NPPES registry since June 27, 2011.
## Identity
- **NPI:** 1063708188 (Entity type: Individual)
- **Enumerated:** June 27, 2011
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 025249 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1275 YORK AVE, New York, NY 10065-6007
- **Phone:** (212) 639-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Memorial Psychiatry Group (NPI 1689645244, New York, NY); Msk Monmouth (NPI 1922459163, Middletown, NJ); Memorial Sloan Kettering Cancer Center At Basking Ridge New Jersey (NPI 1184637886, Basking Ridge, NJ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** August 3, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1063708188) · Data from the CMS NPPES public registry.