Kelly Joan Lundberg, PHD in Salt Lake City, UT - Medicare Psychologist Provider

Kelly Joan Lundberg, PHD is a medicare enrolled "Psychologist - Clinical" provider in Salt Lake City, Utah. Her current practice location is 50 N Medical Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 581-7951.

Kelly Joan Lundberg is licensed to practice in Utah (license number 116971-2501) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669562278.

Contact Information

	Kelly Joan Lundberg, PHD
	50 N Medical Dr, Salt Lake City, UT 84132-0001
	(801) 581-7951
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Joan Lundberg
Gender	Female
Speciality	Psychologist - Clinical
Location	50 N Medical Dr, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669562278
Provider Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 3678525789
Enrollment ID: I20050217000227

Medical Identifiers

Medical identifiers for Kelly Joan Lundberg such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669562278	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	116971-2501 (Utah)	Primary

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 Joan Lundberg allows following entities to bill medicare on her behalf.

Entity Name	University Of Utah Behavioral Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740688613 PECOS PAC ID: 9537483607 Enrollment ID: O20150120001118

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 Joan Lundberg 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 Joan Lundberg, PHD Po Box 581079, Salt Lake City, UT 84158-1079 Ph: (801) 213-3800	Kelly Joan Lundberg, PHD 50 N Medical Dr, Salt Lake City, UT 84132-0001 Ph: (801) 581-7951

Reviews and Comments

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Kelly Joan Lundberg, PHD - Medicare Psychologist in Salt Lake City, UT