Individual provider Active NPI

Kristi Roper, PH.D.

  • Psychologist
  • Dallas, TX
National Provider Identifier
1508807207
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30752 Issued in TX
Practice address
17304 Preston Rd Ste 800
Dallas, TX 75252-5645
Phone
(214) 763-1985
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 30752 TX Primary

Addresses

Primary practice location

17304 Preston Rd Ste 800
Dallas, TX 75252-5645

Mailing address

17304 Preston Rd Ste 800
Dallas, TX 75252-5645
Phone (214) 763-1985

Other identifiers 1

IdentifierTypeStateIssuer
86973AOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040612000710 TX Practitioner - Clinical Psychologist 2466435029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Mind Body Wellness PCGroup PAC ID 6800879438, 4 clinicians

Practice addresses (Care Compare)

17304 Preston Rd
Suite 800
Dallas, TX 75252-5645
Phone (972) 849-8987

5550 Harvest Hill Rd
Dallas, TX 75230-1684
Phone (972) 661-1862

8600 Skyline Dr
Dallas, TX 75243-4198
Phone (214) 355-9000

Merit-based Incentive Payment System (MIPS)

Final score
22.46 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30752TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services PC CurrentSince Sep 7, 2021 Accepting new patients
Behavioral Medicine Associates PLLC CurrentSince May 18, 2021 Accepting new patients
Mind Body Wellness PC Psychologist CurrentSince Jan 1, 2004 Accepting new patients
Mind Body Wellness PC Psychologist Past Accepting new patients

Locations

17304 Preston Rd
Ste 800
Dallas, TX 75252
Phone (214) 763-1985

7557 Rambler Rd
Ste 814
Dallas, TX 75231
Phone (214) 676-7920

3208 Thunderbird Ln
Plano, TX 75075
Phone (972) 422-2214

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1508807207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17304 PRESTON RD STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525645",
            "telephone_number": "214-763-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17304 PRESTON RD STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525645",
            "telephone_number": "214-763-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROPER",
        "first_name": "KRISTI",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "30752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86973A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.