Kimmala Shetef Roundtree, FNP-BC - Medicare Nurse Practitioner in Alexandria, VA

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Kimmala Shetef Roundtree, FNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Alexandria, Virginia. Her current practice location is 1727 King St Ste 3, Alexandria, Virginia. You can reach out to her office (for appointments etc.) via phone at (571) 695-2386.

Kimmala Shetef Roundtree is licensed to practice in Virginia (license number 0024172748) 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 1205210788.

Contact Information

Kimmala Shetef Roundtree, FNP-BC
1727 King St Ste 3,
Alexandria, VA 22314-2700
(571) 695-2386
(571) 695-2252

Map and Direction




Provider's Profile

Full NameKimmala Shetef Roundtree
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1727 King St Ste 3, Alexandria, Virginia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1205210788
  • Provider Enumeration Date: 07/15/2015
  • Last Update Date: 08/07/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0547576589
  • Enrollment ID: I20150904001562

Medical Identifiers

Medical identifiers for Kimmala Shetef Roundtree such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205210788NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 0024172748 (Virginia)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health AC006692 (Maryland)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 0024172748 (Virginia)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. Kimmala Shetef Roundtree allows following entities to bill medicare on her behalf.
Entity NamePrivia Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013042480
PECOS PAC ID: 4385682061
Enrollment ID: O20050422000298
Entity NameGreater Baden Medical Service Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912927344
PECOS PAC ID: 4981632650
Enrollment ID: O20051017000645
Entity NameWalston Health Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023460912
PECOS PAC ID: 0244592798
Enrollment ID: O20180320002959
Entity NamePrestige Medical House Call Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497316269
PECOS PAC ID: 1658704036
Enrollment ID: O20191126002130

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. Kimmala Shetef Roundtree 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 AddressPractice Location Address
Kimmala Shetef Roundtree, FNP-BC
1727 King St Ste 3,
Alexandria, VA 22314-2700

Ph: (571) 695-2386		Kimmala Shetef Roundtree, FNP-BC
1727 King St Ste 3,
Alexandria, VA 22314-2700

Ph: (571) 695-2386

Reviews and Comments


Nurse Practitioner Nurses in Alexandria, VA

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Phone: 703-461-4170    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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