Individual provider Active NPI

Tristan Bugos

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1700696069
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.028779 Issued in IL
Practice address
2511 N Kedzie Blvd
Chicago, IL 60647-2603
Phone
(630) 368-1771
Fax
(708) 658-2750
NPI assigned
Jan 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.028779 IL Primary

Addresses

Primary practice location

2511 N Kedzie Blvd
Chicago, IL 60647-2603

Mailing address

29373 Network PL
Chicago, IL 60673-4419
Phone (847) 390-5900

Other practice location 1

3021 N Sheffield Ave
Chicago, IL 60657-4419
Phone (773) 296-7450

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tbugos415798@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128001185 IL Practitioner - Physical Therapist in Private Practice 8022547611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

2511 N Kedzie Blvd
Chicago, IL 60647-2603
Phone (773) 292-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.028779ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 13, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 13, 2024 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

3021 N Sheffield Ave
Chicago, IL 60657
Phone (773) 296-7450

29373 Network Pl
Chicago, IL 60673

2511 N Kedzie Blvd
Chicago, IL 60647
Phone (773) 292-2700

Interoperability endpoints

  • Direct secure messaging: tbugos415798@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1700696069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734419",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 N KEDZIE BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472603",
            "telephone_number": "630-368-1771",
            "fax_number": "708-658-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3021 N Sheffield Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606574419",
            "country_code": "US",
            "telephone_number": "773-296-7450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUGOS",
        "first_name": "TRISTAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbugos415798@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2511 N Kedzie Blvd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2511 N Kedzie Blvd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.