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RAVEN CROSS
NPI 1114596624
Nurse Practitioner - Psychiatric/Mental Health in San Jose, CA

Active since June 18, 2021PECOS Enrolled
1165 LINCOLN AVE STE 150, SAN JOSE, CA 95125(408) 372-8580 Get Directions Write a Review

NPPES record last updated: August 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 14, 2026, May 25, 2023, Jan 31, 2022 and 1 more (4 updates tracked since 2021).

About Raven Cross NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN CROSS (NPI 1114596624) is an individual psychiatric/mental health provider in San Jose, California, licensed in California (95019647) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in San Jose.

NPPES Registry Identity

NPI1114596624
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameRAVEN CROSS
Location Address1165 LINCOLN AVE STE 150San Jose, CA 95125-3045
Mailing Address1165 Lincoln Ave Ste 150San Jose, CA 95125-3045
Phone(408) 372-8580
Sole ProprietorYes
Enumeration DateJune 18, 2021
Last NPPES UpdateAugust 14, 20264 updates tracked since enumeration
NPPES CertifiedAugust 14, 2026
✔ NPI 1114596624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in CA · 95019647✔ Licensed in VA · 0024183375
Also ListedRegistered Nurse · Psychiatric/Mental Health, Child & AdolescentTaxonomy 163WP0807X · License 95142217 (CA)
1165 LINCOLN AVE STE 150, San Jose, CA 95125
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Secondary Practice Location 1

Location 11898 The AlamedaSan Jose, CA 95126-1733 · Phone (408) 928-1700 · Fax (408) 928-1701

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raven Cross is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Raven Cross reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grow Healthcare Group PC
1.8 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385
Grow Healthcare Group PA
2,563 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,424 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95125 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Raven Cross's NPI number?

The NPI number for Raven Cross is 1114596624. It was assigned to this individual provider in the NPPES registry on June 18, 2021.

Where is Raven Cross located?

Raven Cross practices at 1165 Lincoln Ave Ste 150, San Jose, CA 95125. The listed phone number is (408) 372-8580.

What is Raven Cross's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Raven Cross enrolled in Medicare?

Yes. Raven Cross is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Raven Cross's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raven Cross reassigns Medicare benefits to 2 organizations: Grow Healthcare Group PC (San Jose, CA) and Grow Healthcare Group PA (Miami, FL). 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 Raven Cross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raven Cross accept?

Health plans from Oscar Health list Raven Cross as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raven Cross was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.