Active NPI
Samantha Roop, PSYD
- Clinical Neuropsychologist
- Austin, TX
National Provider Identifier
1174313472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 39995
- Practice address
- 3660 Stoneridge Rd Ste F101
Austin, TX 78746-7759 - Phone
- (512) 329-8222
- NPI assigned
- May 9, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 39995 | TX | Primary |
Addresses
Primary practice location
3660 Stoneridge Rd Ste F101
Austin, TX 78746-7759
Mailing address
6202 Roxbury Dr Apt 10302
San Antonio, TX 78238-1385
Phone (815) 474-2061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 16, 2025 through Dec 16, 2027
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3660 Stoneridge Rd
Suite F101
Austin, TX 78746-7759
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39995 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1174313472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6202 ROXBURY DR APT 10302",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782381385",
"telephone_number": "815-474-2061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3660 STONERIDGE RD STE F101",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787467759",
"telephone_number": "512-329-8222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOP",
"first_name": "SAMANTHA",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-09",
"last_updated": "2025-05-09",
"certification_date": "2025-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "39995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.