MALLORY A. BOOTH (PA-C) – Medical Physician Assistant, NPI 1073960118
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for MALLORY A. BOOTH (PA-C)
800 1ST ST STE 410
MACON, GA 312018306
Phone: (478) 743-7068
Fax: (478) 741-1354
Type: Mailing
1050 Ruby Tyler Pkwy
Tuscaloosa, AL 354042958
Phone: (478) 743-7068
Fax: (478) 741-1354
Type: Location
4515 SOUTHLAKE PKWY STE 200
HOOVER, AL 352443319
Phone: (205) 313-7246
Fax: (205) 939-1911
Type: Mailing
114 Sutherlin Dr Ste C-1
Warner Robins, GA 310882259
Phone: (478) 743-7068
Fax: (478) 741-1354
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 105 Open Payments records for all available years, with a total value of $2,319.
Total Amount is formed as General ($2,319) + Research ($0) + Ownership ($0) = $2,319.
Last reported payment date: 2024-10-07 • Largest payer in this snapshot: ABBVIE INC. ($263).
Total Amount
$2,319
General + Research + Ownership
Payments
105
Total payment records
General Amount
$2,319
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $263 |
| Seagen Inc. | $228 |
| Novartis Pharmaceuticals Corporation | $177 |
| Incyte Corporation | $145 |
| Merck Sharp & Dohme LLC | $126 |
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: 2023-10-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231006001899 | I | Physician Assistant | AL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 45 | 41 | $0 |
Insurance plans in this area (ZIP 31201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AL | |
| O T O L A R Y N G O L O G Y | AL | |
| Nurse Practitioner | AL | |
| Qualified Audiologist | AL |
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