Individual provider Active NPI

Kamalika Roy, MD

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1700134517
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD180970 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 494-6176
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD61199162 WA
Psychiatry Physician 2084P0800X 4301101293 MI
Psychiatry Physician 2084P0800X MD180970 OR Primary
Psychosomatic Medicine Physician 2084P0015X MD180970 OR

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other practice location 1

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (206) 520-5000

Other identifiers 1

IdentifierTypeStateIssuer
1700134517MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006001312 OR Practitioner - Psychiatry 5395047179 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

1225 NE 2ND Ave
Portland, OR 97232-2003
Phone (503) 944-8000

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center Psychiatry CurrentSince Nov 18, 2022 Accepting new patients
University Professional Services CurrentSince Nov 1, 2022 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Nov 1, 2022 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Nov 18, 2022 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

Interoperability endpoints

  • Direct secure messaging: kroy150542@direct.ohsu.edu

Organizations & group practices 7

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1700134517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-6176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Eastlake Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981094405",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "KAMALIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61199162",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301101293",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD180970",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "OR",
            "license": "MD180970",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700134517",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.