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

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 Name	Kelly A Bushur
Gender	Female
Speciality	Clinical Psychologist
Experience	28 Years
Location	400 S Lewis Ln, Carbondale, Illinois
Accepts Medicare Assignments	Yes. 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.

Identifier	Type	State	Issuer
1629248406	NPI	-	NPPES
370966854006	Medicaid	IL
370966854015	Medicaid	IL
370966854002	Medicaid	IL
370966854024	Medicaid	IL
370966854005	Medicaid	IL
640701	Other	IL	MEDICARE GROUP ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	071005772 (Illinois)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
St. Louis Behavioral Medicine Institute Inc	3173428638	40

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 Name	St. Louis Behavioral Medicine Institute Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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

Psychologist in Carbondale, IL

Jacqueline N Buck, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3200 Fishback Rd, Carbondale, IL 62901 Phone: 618-457-1111 Fax: 618-351-1419
Christian Hope Gillespie, PHD, LCP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 810 N Wall St, Carbondale, IL 62901 Phone: 310-270-5878
Dr. Matthew Eric Denis, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3412 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-4488 Fax: 618-457-8844
Sylvia Lane, PSYD, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 810 N Wall St, Carbondale, IL 62901 Phone: 773-551-7536
Dr. Jeffrey Saunders Kellogg, PSY.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3412 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-4488 Fax: 618-457-8844
Aireal Dee Weber, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-6703 Fax: 618-529-4563
Dr. Warren Thomas Bush, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 374 E Grand Ave, Carbondale, IL 62901 Phone: 618-453-5371

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