Mr Karl Raymond Gundersen, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Granite City, Illinois. He went to University Of Kansas School Of Med (kc/wich/sal) and graduated in 1996 and has 29 years of diverse experience with area of expertise as Psychiatry. He is a member of the group practice Mellow Medical Inc A Professional Corporation and his current practice location is
2120 Madison Ave, Ste 405, Granite City, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 876-0653.
Mr Karl Raymond Gundersen is licensed to practice in Illinois (license number 036105102) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1548362775.
Physician's Profile
| Full Name | Mr Karl Raymond Gundersen |
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| Gender | Male |
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| Speciality | Psychiatry |
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| Experience | 29 Years |
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| Location | 2120 Madison Ave, Granite City, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Karl Raymond Gundersen attended and graduated from University Of Kansas School Of Med (kc/wich/sal) in 1996
NPI Data:
- NPI Number: 1548362775
- Provider Enumeration Date: 09/01/2006
- Last Update Date: 08/14/2012
Medicare PECOS Information:
- PECOS PAC ID: 8729237656
- Enrollment ID: I20160322002267
Medical Identifiers
Medical identifiers for Mr Karl Raymond Gundersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1548362775 | NPI | - | NPPES |
| 205739907 | Other | MO | MEDICAID |
| 036105102 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036105102 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mellow Medical Inc A Professional Corporation | 3375767403 | 27 |
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. Mr Karl Raymond Gundersen allows following entities to bill medicare on his behalf.
| Entity Name | Mellow Medical Inc A Professional Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407275886
PECOS PAC ID: 3375767403
Enrollment ID: O20140611002222 |
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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. Mr Karl Raymond Gundersen 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 Address | Practice Location Address |
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Mr Karl Raymond Gundersen, MD
2120 Madison Ave, Ste 405,
Granite City, IL 62040
Ph: (618) 876-0653 | Mr Karl Raymond Gundersen, MD
2120 Madison Ave, Ste 405,
Granite City, IL 62040
Ph: (618) 876-0653 |
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