1. Home
  2. Directory
  3. Virginia
  4. Alexandria
  5. Nurse Practitioner
  6. NPI Profile

KIMMALA SHETEF ROUNDTREE FNP-BC
NPI 1205210788
Nurse Practitioner - Psychiatric/Mental Health in Alexandria, VA

Active since July 15, 2015PECOS EnrolledAccepts Medicare Assignment
1727 KING ST STE 3, ALEXANDRIA, VA 22314(571) 695-2386(571) 695-2252 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 7, 2024, Dec 12, 2022, Jan 10, 2022 (3 updates tracked since 2022).

About Kimmala Shetef Roundtree Fnp-bc NPPES

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

KIMMALA SHETEF ROUNDTREE FNP-BC (NPI 1205210788) is an individual psychiatric/mental health provider in Alexandria, Virginia, licensed in Virginia (0024172748) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Brandywine, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205210788
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKIMMALA SHETEF ROUNDTREECredential: FNP-BC
Location Address1727 KING ST STE 3Alexandria, VA 22314-2700
Mailing Address1727 King St Ste 3Alexandria, VA 22314-2700 · (571) 695-2386 · Fax (571) 695-2252
Phone(571) 695-2386
Fax(571) 695-2252
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJuly 15, 2015
Last NPPES UpdateAugust 7, 20243 updates tracked since enumeration
NPPES CertifiedAugust 7, 2024
✔ NPI 1205210788 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 VA · 0024172748✔ Licensed in MD · AC006692
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 0024172748 (VA)
1727 KING ST STE 3, Alexandria, VA 22314
Open in Google Maps ↗

Secondary Practice Location 1

Location 17450 Albert Rd Fl 3Brandywine, MD 20613-3035 · Phone (301) 888-2233 · Fax (301) 997-1489

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 and accepts Medicare assignment

Kimmala Shetef Roundtree Fnp-bc 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.

PECOS PAC ID547576589
PECOS Enrollment IDI20160805000980
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

5

Medicare enrollment records show Kimmala Roundtree reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Walston Health Services LLC
5.3 mi
Mental Health (Including Community Mental Health Center)
6164 FULLER CT
Alexandria, VA 22310
  • Reassigned Medicare billing, District of Columbia enrollment
  • 4 clinicians in this Medicare group
NPI 1023460912 (703) 924-9810
Privia Medical Group, LLC
6.0 mi
Internal Medicine
950 N GLEBE RD STE 700
Arlington, VA 22203
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,534 clinicians in this Medicare group
NPI 1013042480 (571) 366-8850
Prestige Medical House Call LLC
10 mi
Internal Medicine
8315 LEE HWY STE 202
Fairfax, VA 22031
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 15 clinicians in this Medicare group
NPI 1497316269 (703) 352-1959
Greater Baden Medical Service Incorporated
14 mi
Federally Qualified Health Center (FQHC)
7450 ALBERT RD FL 2
Brandywine, MD 20613
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • 57 clinicians in this Medicare group
NPI 1912927344 (301) 888-2233
Brightview LLC
152 mi
Rehabilitation, Substance Use Disorder
3704 OLD FOREST RD
Lynchburg, VA 24501
  • Reassigned Medicare billing, Virginia enrollment
  • 61 clinicians in this Medicare group
NPI 1649786260 (833) 510-4357

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 22314 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

A BALANCED APPROACH TO BEHAVIORAL & MENTAL HEALTH
Nurse Practitioner (Psychiatric/Mental Health)
1727 KING ST STE 3
ALEXANDRIA, VA 22314
Alexandria City (571) 695-2386

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 Kimmala Roundtree's NPI number?

The NPI number for Kimmala Roundtree is 1205210788. It was assigned to this individual provider in the NPPES registry on July 15, 2015.

Where is Kimmala Roundtree located?

Kimmala Roundtree practices at 1727 King St Ste 3, Alexandria, VA 22314. The listed phone number is (571) 695-2386.

What is Kimmala Roundtree's specialty?

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

Is Kimmala Roundtree enrolled in Medicare?

Yes. Kimmala Roundtree 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 Kimmala Roundtree's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimmala Roundtree reassigns Medicare benefits to 5 organizations: Walston Health Services LLC (Alexandria, VA), Privia Medical Group, LLC (Arlington, VA), Prestige Medical House Call LLC (Fairfax, VA), Greater Baden Medical Service Incorporated (Brandywine, MD) and Brightview LLC (Lynchburg, VA). 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 Kimmala Roundtree's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimmala Roundtree accept?

Health plans from Oscar Health list Kimmala Roundtree 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 Kimmala Roundtree was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.