1. Home
  2. Directory
  3. Michigan
  4. Saginaw
  5. Urology
  6. NPI Profile

TRI CITY UROLOGY ASSOCIATES PC
NPI 1366463101
Urology in Saginaw, MI

Active since July 21, 2006CLIA Certified · 2 labs
1117 S WASHINGTON AVE, SAGINAW, MI 48601(989) 791-4020(989) 791-5152 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2021, Mar 30, 2021 (2 updates tracked since 2021).

About Tri City Urology Associates Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRI CITY UROLOGY ASSOCIATES PC (NPI 1366463101) is a healthcare organization registered as an urology in Saginaw, Michigan and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Tamara Lynn Bahm, Medical Biller, as its authorized official.

NPPES Registry Identity

NPI1366463101
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameTRI CITY UROLOGY ASSOCIATES PC
Location Address1117 S WASHINGTON AVESaginaw, MI 48601
Mailing Address1117 S Washington AveSaginaw, MI 48601 · (989) 791-4020 · Fax (989) 791-5152
Phone(989) 791-4020
Fax(989) 791-5152
Organization SubpartNo
Authorized OfficialTamara Lynn BahmMedical Biller · (989) 791-4020
Enumeration DateJuly 21, 2006
Last NPPES UpdateSeptember 20, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2023
✔ NPI 1366463101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1117 S WASHINGTON AVE, Saginaw, MI 48601
Open in Google Maps ↗

Secondary Practice Locations 2

Location 14 Columbus Ave Ste 130Bay City, MI 48708-6469 · Phone (989) 895-2636 · Fax (989) 895-2636
Location 2565 Progress St Ste DWest Branch, MI 48661-8601 · Phone (989) 895-2634

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tri City Urology Associates Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20060809000077Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Tri City Urology Associates PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Aditya Bulusu, MD
Urology
NPI 1982697074
1117 S WASHINGTON AVE
Saginaw, MI 48601
(989) 791-4020
✔ PECOS✔ Accepts MedicareSame address
Steven Jensen, MD
Urology
NPI 1154314193
1117 S WASHINGTON AVE
Saginaw, MI 48601
(989) 791-4020
✔ PECOS✔ Accepts MedicareSame address
Glenn Kershen, MD
Urology
NPI 1013900190
1117 S WASHINGTON AVE
Saginaw, MI 48601
(989) 791-4020
✔ PECOS✔ Accepts MedicareSame address
Karen Dziuba, NP
Nurse Practitioner
NPI 1710088802
630 PROGRESS ST
West Branch, MI 48661
(989) 345-5020
✔ PECOS60 mi
Mahmood Hasan, M.D.
Urology
NPI 1306822218
314 M 55 W
Tawas City, MI 48763
(989) 362-4484
✔ PECOS63 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0949204

Tri-City Urology PC · Saginaw, MI
Active · expires Jul 27, 2028
CLIA Number23D0949204
Laboratory TypePhysician Office
Certificate Effective DateJuly 28, 2026
Certificate Expiration DateJuly 27, 2028
Laboratory DirectorSteven L. Jensen
Laboratory Phone(989) 791-4020
Laboratory LocationTri-City Urology PC1117 S Washington, Saginaw, MI 48601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 23D2079120

Tri City Urology P C · West Branch, MI
Active · expires Jun 10, 2028
CLIA Number23D2079120
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorGlenn E. Kershen
Laboratory Phone(989) 791-4020
Laboratory LocationTri City Urology P C565 Progress Street Suite D, West Branch, MI 48661
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tri City Urology Associates PC's NPI number?

The NPI number for Tri City Urology Associates PC is 1366463101. It was assigned to this organization in the NPPES registry on July 21, 2006.

Where is Tri City Urology Associates PC located?

Tri City Urology Associates PC is located at 1117 S Washington Ave, Saginaw, MI 48601. The listed phone number is (989) 791-4020.

What is Tri City Urology Associates PC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Tri City Urology Associates PC enrolled in Medicare?

Yes. Tri City Urology Associates PC is registered in the Medicare PECOS enrollment system.

When is Tri City Urology Associates PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Tri City Urology Associates PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Tri City Urology Associates PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Urology (4) and Nurse Practitioner (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tri City Urology Associates PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Tri City Urology Associates PC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 34 other insurers list Tri City Urology Associates PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tri City Urology Associates PC was last updated on September 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.