DR. KIMRA K ROUNDY PSY.D.
NPI 1518157072
Psychologist - Clinical in Portland, OR

Q: What is Kimra Roundy's NPI number?

The NPI number for Kimra Roundy is 1518157072. It was assigned to this individual provider in the NPPES registry on July 30, 2007.

Q: What is Kimra Roundy's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Kimra Roundy enrolled in Medicare?

No. Kimra Roundy has opted out of Medicare through March 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kimra Roundy was last updated on November 13, 2023. 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.

Active since July 30, 2007Opted out of Medicare · through Mar 9, 2027

13908 SE STARK ST STE A, PORTLAND, OR 97233(503) 255-2343(503) 255-2344 Get Directions Write a Review

NPPES record last updated: November 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Kimra K Roundy Psy.d. NPPES

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

DR. KIMRA K ROUNDY PSY.D. (NPI 1518157072) is an individual clinical provider in Portland, Oregon, licensed in Oregon (3166) and active in the NPI registry since July 2007. She has opted out of Medicare through March 9, 2027 and maintains a secondary practice location in Berkeley.

NPPES Registry Identity

NPI1518157072

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. KIMRA K ROUNDYCredential: PSY.D.

Location Address13908 SE STARK ST STE APortland, OR 97233-2161

Mailing Address13908 Se Stark St Ste APortland, OR 97233-2161 · (503) 255-2343 · Fax (503) 255-2344

Phone(503) 255-2343

Fax(503) 255-2344

Sole ProprietorNo

Enumeration DateJuly 30, 2007

Last NPPES UpdateNovember 13, 2023

NPPES CertifiedNovember 13, 2023

✔ NPI 1518157072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OR · 3166

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License RPS2012267 (CA)

13908 SE STARK ST STE A, Portland, OR 97233

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Secondary Practice Location 1

Location 13075 Adeline St Ste 120Berkeley, CA 94703-2579 · Phone (510) 815-9505 · Fax (510) 848-4445

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Providence Health Plan, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kimra K Roundy Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 9, 2023 through March 9, 2027.

Opt-Out Effective DateMarch 9, 2023

Opt-Out In Effect ThroughMarch 9, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97233 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

$176.88 typical visit price

range $58.99 – $176.88

Typical copayment $44.22 (range $14.74 – $44.22)

Most-billed visit code 99205

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

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 2

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

KORIE KATHLYNE MULLENBERG ARNP-BC

Nurse Practitioner (Psychiatric/Mental Health)

13908 SE STARK ST STE A
PORTLAND, OR 97233

Multnomah County (503) 255-2343

DINA PAULA FILOTEO-NICHOLS NP

Nurse Practitioner (Psychiatric/Mental Health)

13908 SE STARK ST STE A
PORTLAND, OR 97233

Multnomah County (503) 255-2344

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 Kimra Roundy's NPI number?

The NPI number for Kimra Roundy is 1518157072. It was assigned to this individual provider in the NPPES registry on July 30, 2007.

Where is Kimra Roundy located?

Kimra Roundy practices at 13908 SE Stark St Ste A, Portland, OR 97233. The listed phone number is (503) 255-2343.

What is Kimra Roundy's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kimra Roundy enrolled in Medicare?

No. Kimra Roundy has opted out of Medicare through March 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Kimra Roundy accept?

Health plans from BridgeSpan Health Company, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Kimra Roundy 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 Kimra Roundy was last updated on November 13, 2023. 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.