Adam T Kandulski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AK067829 Issued in MI

Practice address

1015 S Washington Ave FL 2
Saginaw, MI 48601

Phone

(989) 753-5300

Fax

(989) 753-5099

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adam.kandulski.1@11016.direct.athenahealth.com

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376
  NPD (past)
• Mymichigan Medical Center Saginaw

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1801218680
  NPD (past)
• Mymichigan Medical Center Saginaw

  • Family Medicine Physician
  • Frankenmuth, MI
  • NPI 1912995465
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1962410472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487640779",
            "telephone_number": "989-753-5300",
            "fax_number": "989-753-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S WASHINGTON AVE FL 2",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48601",
            "telephone_number": "989-753-5300",
            "fax_number": "989-753-5099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 N Michigan Ave",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486024751",
            "country_code": "US",
            "telephone_number": "989-753-5300",
            "fax_number": "989-753-5099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5810 Gratiot Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486386063",
            "country_code": "US",
            "telephone_number": "989-790-3650",
            "fax_number": "989-790-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDULSKI",
        "first_name": "ADAM",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "AK067829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "0986021",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0730789",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0800910121",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4524151",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adamkandulski@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1015 S Washington Ave Fl 2",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kara Kaminski
• Marilyn Sue Kamp, PHARM.D
• Zeina Kanaan, DDS
• Jennifer Kanary, LLBSW
• Anushiya Kandiah, MD
• Tai Kang Sr.
• Laurel Kangas
• Craig Kanicki
• Terence Kanuszewski, CCAR
• Alexandra Kanyo

• Family Medicine Physician in Saginaw, MI
• Providers in Saginaw, 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 Apr 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.