Priya Pullukat Bhattacharyya, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301508990 Issued in MI

Practice address

1540 Lake Lansing Rd Ste 203
Lansing, MI 48912-3757

Phone

(517) 913-6711

Fax

(517) 913-6712

NPI assigned

Aug 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Priya Ann Pullukat Former name

Medicare fee-for-service enrollment

Enrolled in IL, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Michigan Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Physician Group PCGroup PAC ID 0648277830, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Legacy Physician Group, P.C.

  • Specialist
  • Lansing, MI
  • NPI 1801800719
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Vista Family Medicine Inc

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1144214644
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672
  Care Compare affiliation

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1821289315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HOLMES AVE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141418",
            "telephone_number": "312-237-7606",
            "fax_number": "517-913-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD STE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123757",
            "telephone_number": "517-913-6711",
            "fax_number": "517-913-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTACHARYYA",
        "first_name": "PRIYA",
        "middle_name": "PULLUKAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-121103",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301508990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRIYA",
            "last_name": "PULLUKAT",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deepanshu Bhardwaj, DDS
• Ajay Kumar Bhargava, PT
• Shweta Bhatnagar, DO
• Archana Bhatt, MD
• Hitesh Mahadev Bhatt, D.O
• Farhan Bhatti, M.D.
• BHG Lxxxiii, LLC
• Sidra B Bhuller, D.O
• Jane Bidwell, LMSW
• Alina Bierwagen, MA, LLPC

• Family Medicine Physician in Lansing, MI
• Providers in Lansing, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.