Kelly Ann Pettit, PSYD in Mchenry, IL - Medicare Clinical Psychologist Provider

Kelly Ann Pettit, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Mchenry, Illinois. She graduated from medical school in 2008 and has 18 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Neuroclinic And Assessments Llc and her current practice location is 659 Ridgeview Dr, Mchenry, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 344-1999.

Kelly Ann Pettit is licensed to practice in Iowa (license number 117693) 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 1194999409.

Contact Information

	Kelly Ann Pettit, PSYD
	659 Ridgeview Dr, Mchenry, IL 60050-7012
	(815) 344-1999
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Ann Pettit
Gender	Female
Speciality	Clinical Psychologist
Experience	18 Years
Location	659 Ridgeview Dr, Mchenry, 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 Ann Pettit graduated from medical school in 2008

NPI Data:

NPI Number: 1194999409
Provider Enumeration Date: 04/17/2008
Last Update Date: 05/29/2023

Medicare PECOS Information:

PECOS PAC ID: 5890988984
Enrollment ID: I20101021000562

Medical Identifiers

Medical identifiers for Kelly Ann Pettit such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194999409	NPI	-	NPPES
071007917	Other	IL	STATE LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	20042375A (Indiana)	Secondary
103TC0700X	Psychologist - Clinical	071007917 (Illinois)	Secondary
103TC0700X	Psychologist - Clinical	117693 (Iowa)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Neuroclinic And Assessments Llc	1658524475	4

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 Ann Pettit allows following entities to bill medicare on her behalf.

Entity Name	Neuroclinic And Assessments Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053673988 PECOS PAC ID: 1658524475 Enrollment ID: O20130103000288

Entity Name	Deer Oaks Mid-west Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154978476 PECOS PAC ID: 2264762681 Enrollment ID: O20190927002974

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 Ann Pettit 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 Ann Pettit, PSYD 755 Mcardle Dr Ste C, Crystal Lake, IL 60014-1717 Ph: (815) 338-6600	Kelly Ann Pettit, PSYD 659 Ridgeview Dr, Mchenry, IL 60050-7012 Ph: (815) 344-1999

Reviews and Comments

Psychologist in Mchenry, IL

Dr. Joshua C Lavigne, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 659 Ridgeview Dr, Mchenry, IL 60050 Phone: 815-344-1999 Fax: 815-516-5171
Mr. Todd Christian Evans, EDS., MA, MED Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3218 S Woods Ave, Mchenry, IL 60051 Phone: 847-254-8690
Mr. Peter Thomas, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 814 N Mill St, Unit 5, Mchenry, IL 60050 Phone: 815-385-6004 Fax: 815-385-6062
Mark Pumper, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4100 Veteran's Pkwy, Mchenry, IL 60050 Phone: 818-385-6400
Dr. Caryn P Andrews, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2507 N Richmond Rd, Mchenry, IL 60051 Phone: 815-338-6600
Tina Breitenbach, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1012 N Green St, Mchenry, IL 60050 Phone: 815-363-3087

Kelly Ann Pettit, PSYD - Medicare Psychologist in Mchenry, IL