KYLEE J ROLLER PH.D.
NPI 1750415873
Psychologist in Buxton, ND

Active since March 14, 2007PECOS Enrolled
16771 15TH ST NE, BUXTON, ND 58218(701) 792-6488(701) 335-7100 Get Directions Write a Review

NPPES record last updated: January 15, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 15, 2021, Dec 30, 2020, Dec 20, 2017 and 2 more (5 updates tracked since 2016).

About Kylee J Roller Ph.d. NPPES

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

KYLEE J ROLLER PH.D. (NPI 1750415873) is an individual psychologist in Buxton, North Dakota and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Forks.

NPPES Registry Identity

NPI1750415873
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKYLEE J ROLLERCredential: PH.D.
Location Address16771 15TH ST NEBuxton, ND 58218-9239
Mailing Address16771 15th St NeBuxton, ND 58218-9239 · (701) 792-6488 · Fax (701) 335-7100
Fax(701) 335-7100
Sole ProprietorNo
Enumeration DateMarch 14, 2007
Last NPPES UpdateJanuary 15, 20215 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2021
✔ NPI 1750415873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
16771 15TH ST NE, Buxton, ND 58218

Secondary Practice Location 1

Location 12808 17th Ave SGrand Forks, ND 58201-4010 · Phone (701) 746-8376 · Fax (701) 746-9872

Other Identifiers 1

Medicaid054519ND

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kylee J Roller Ph.d. 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 Reassignment

Medicare enrollment records show Kylee Roller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical
2808 17TH AVE S
Grand Forks, ND 58201
  • Reassigned Medicare billing, North Dakota enrollment
  • 12 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.

Other Providers at the Same Location NPPES

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

Clinic/Center (Mental Health (Including Community Mental Health Center))
16771 15TH ST NE
BUXTON, ND 58218

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 Kylee Roller's NPI number?

The NPI number for Kylee Roller is 1750415873. It was assigned to this individual provider in the NPPES registry on March 14, 2007.

Where is Kylee Roller located?

Kylee Roller practices at 16771 15th St NE, Buxton, ND 58218. The listed phone number is (701) 792-6488.

What is Kylee Roller's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kylee Roller enrolled in Medicare?

Yes. Kylee Roller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kylee Roller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kylee Roller reassigns Medicare benefits to Lipp, Carlson, Witucki & Associates, Ltd (Grand Forks, ND). The 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 Kylee Roller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kylee Roller accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Kylee Roller 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 Kylee Roller was last updated on January 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.