Kylee J Roller, PHD is a medicare enrolled "Psychologist" provider in Buxton, North Dakota. Her current practice location is
16771 15th St Ne, Buxton, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 792-6488.
Kylee J Roller is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750415873.
Healthcare Provider's Profile
| Full Name | Kylee J Roller |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 16771 15th St Ne, Buxton, North Dakota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750415873
- Provider Enumeration Date: 03/14/2007
- Last Update Date: 01/15/2021
Medicare PECOS Information:
- PECOS PAC ID: 3779888292
- Enrollment ID: I20160222001488
Medical Identifiers
Medical identifiers for Kylee J Roller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750415873 | NPI | - | NPPES |
| 054519 | Medicaid | ND | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kylee J Roller allows following entities to bill medicare on her behalf.
| Entity Name | Lipp Carlson Witucki & Associates Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043316961
PECOS PAC ID: 2062408701
Enrollment ID: O20040420001654 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kylee J Roller is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kylee J Roller, PHD
16771 15th St Ne,
Buxton, ND 58218-9239
Ph: (701) 792-6488 | Kylee J Roller, PHD
16771 15th St Ne,
Buxton, ND 58218-9239
Ph: (701) 792-6488 |
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