DR. MADHAV R BODDULA (M.D., M.P.H.) – Orthopaedic Surgery Physician, NPI 1740355643

DR. MADHAV R BODDULA (M.D., M.P.H.) is a healthcare provider. based in Alhambra, California. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials M.D., M.P.H.. They hold a License No. A96091 (CA). The NPI Number for DR. MADHAV R BODDULA (M.D., M.P.H.) is 1740355643

Main info

Male
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. MADHAV R BODDULA (M.D., M.P.H.)
NPI
1740355643
Phone
(714) 686-8655
Address
580 W MAIN ST APT 128
Enumeration Date
24 November 2006
Last Update Date
1 December 2021

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5624613000
Graduation Year
2004 (22 years ago)
PAC ID
3577612324
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20090527000363
Address ID
CA902422814DO9449XHWYX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,024 ORTHOPEDIC SURGERY in CA

Provider Addresses for DR. MADHAV R BODDULA (M.D., M.P.H.)

  • 580 W MAIN ST APT 128

    ALHAMBRA, CA 918013368

    Phone: (714) 686-8655

    Type: Mailing

  • 1200 N. STATE ST, GNH 3900

    LOS ANGELES, CA 90033

    Phone: (323) 226-7210

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-05-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090527000363IOrthopedic SurgeryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Does DR. MADHAV R BODDULA (M.D., M.P.H.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. MADHAV R BODDULA (M.D., M.P.H.) uses 1740355643.
Does CMS list DR. MADHAV R BODDULA (M.D., M.P.H.) as active?
Yes — DR. MADHAV R BODDULA (M.D., M.P.H.) is active in the NPI listing used on this page.
What is DR. MADHAV R BODDULA (M.D., M.P.H.)'s primary classification?
Orthopaedic Surgery Physician is the headline specialty for DR. MADHAV R BODDULA (M.D., M.P.H.) here. Clinical services aligned with this taxonomy classification.
Where is DR. MADHAV R BODDULA (M.D., M.P.H.) based?
DR. MADHAV R BODDULA (M.D., M.P.H.) is tied to Alhambra, California in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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