Individual provider Active NPI

Aditya D. Bulusu, MD

  • Urology Physician
  • Saginaw, MI
National Provider Identifier
1982697074
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
AB076885 Issued in MI
Practice address
1117 S Washington Ave
Saginaw, MI 48601-2558
Phone
(989) 791-4020
Fax
(989) 921-8765
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X AB076885 MI Primary

Addresses

Primary practice location

1117 S Washington Ave
Saginaw, MI 48601-2558

Mailing address

1117 S Washington Ave
Saginaw, MI 48601-2558
Phone (989) 791-4020

Other practice location 1

565 Progress St Ste D
West Branch, MI 48661-8601
Phone (989) 791-4020

Other practice location 2

4 Columbus Ave Ste 101
Bay City, MI 48708-6457
Phone (989) 895-2634

Other identifiers 7

IdentifierTypeStateIssuer
340019505OtherMITRI CARE
4279350MedicaidMI
0990537OtherMIHEALTHPLUS-BAY
0990461OtherMIHEALTHPLUS-SAGINAW
340G310500OtherMIBLUE CROSS
5272733OtherMIAETNA
340019505OtherMIRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address helen@tricityuro.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100916000716 MI Practitioner - Urology 8325163181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-City Urology Associates PCGroup PAC ID 8729081963, 3 clinicians

Practice addresses (Care Compare)

1117 S Washington Ave
Saginaw, MI 48601-2558
Phone (989) 791-4020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.27 of 100Reported as group
Quality
96.55
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AB076885MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri City Urology Associates PC Urology CurrentSince May 1, 2001 Accepting new patients

Locations

4 Columbus Ave
Ste 101
Bay City, MI 48708
Phone (989) 895-2634

4 Columbus Ave
Ste 130
Bay City, MI 48708
Phone (989) 895-2634

1117 S Washington Ave
Saginaw, MI 48601
Phone (989) 791-4020

565 Progress St
Ste D
West Branch, MI 48661
Phone (248) 620-1900

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1982697074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012558",
            "telephone_number": "989-791-4020",
            "fax_number": "989-921-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012558",
            "telephone_number": "989-791-4020",
            "fax_number": "989-921-8765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Progress St Ste D",
            "address_purpose": "LOCATION",
            "city": "West Branch",
            "state": "MI",
            "postal_code": "486618601",
            "country_code": "US",
            "telephone_number": "989-791-4020",
            "fax_number": "989-791-5152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Columbus Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487086457",
            "country_code": "US",
            "telephone_number": "989-895-2634",
            "fax_number": "989-895-2636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULUSU",
        "first_name": "ADITYA",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "AB076885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "340019505",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4279350",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS-BAY",
            "identifier": "0990537",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS-SAGINAW",
            "identifier": "0990461",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "340G310500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5272733",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340019505",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "helen@tricityuro.com",
            "affiliation": "N",
            "address_1": "1117 S Washington Ave",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486012558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.