Kelly A Bushur, CP PHD - Medicare Psychologist in Carbondale, IL

Kelly A Bushur, CP PHD is a medicare enrolled "Psychologist - Clinical" provider in Carbondale, Illinois. She graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice St. Louis Behavioral Medicine Institute Inc and her current practice location is 400 S Lewis Ln, Carbondale, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 519-9900.

Kelly A Bushur is licensed to practice in Illinois (license number 071005772) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629248406.

Contact Information

Kelly A Bushur, CP PHD
400 S Lewis Ln,
Carbondale, IL 62901-3547
(618) 519-9900
(618) 529-1384

Map and Direction




Healthcare Provider's Profile

Full NameKelly A Bushur
GenderFemale
SpecialityClinical Psychologist
Experience28 Years
Location400 S Lewis Ln, Carbondale, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kelly A Bushur graduated from medical school in 1996
  NPI Data:
  • NPI Number: 1629248406
  • Provider Enumeration Date: 03/07/2008
  • Last Update Date: 10/23/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 3577746197
  • Enrollment ID: I20141001000447

Medical Identifiers

Medical identifiers for Kelly A Bushur such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629248406NPI-NPPES
370966854006MedicaidIL
370966854015MedicaidIL
370966854002MedicaidIL
370966854024MedicaidIL
370966854005MedicaidIL
640701OtherILMEDICARE GROUP ID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 071005772 (Illinois)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St. Louis Behavioral Medicine Institute Inc317342863844

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. Kelly A Bushur allows following entities to bill medicare on her behalf.
Entity NameSt. Louis Behavioral Medicine Institute Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487732335
PECOS PAC ID: 3173428638
Enrollment ID: O20031223000497

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. Kelly A Bushur 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
Kelly A Bushur, CP PHD
Po Box 577,
Carterville, IL 62918-0577

Ph: (618) 985-8221
Kelly A Bushur, CP PHD
400 S Lewis Ln,
Carbondale, IL 62901-3547

Ph: (618) 519-9900

Reviews and Comments


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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.

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