DR. GENESIS BOWEN (MD) – Obstetrics & Gynecology Physician, NPI 1104805050

DR. GENESIS BOWEN (MD) is a healthcare provider. based in Stone mountain, Georgia. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 060706 (GA). The NPI Number for DR. GENESIS BOWEN (MD) is 1104805050

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. GENESIS BOWEN (MD)
NPI
1104805050
Phone
(770) 469-9961
Address
1805 Parke Plaza Cir Ste 102
Enumeration Date
10 January 2006
Last Update Date
17 March 2018

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
-
Graduation Year
2000 (26 years ago)
PAC ID
8527020189
Group Practice PAC ID
3476605841
Professional Enrollment ID
I20081025000028
Address ID
GA300335924DE2801XRDXX404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,266 OBSTETRICS/GYNECOLOGY in GA

Provider Addresses for DR. GENESIS BOWEN (MD)

  • 1805 Parke Plaza Cir Ste 102

    Stone Mountain, GA 300873646

    Phone: (770) 469-9961

    Fax: (770) 413-0030

    Type: Location

  • North Decatur Road, Decatur, DeKalb County, Georgia, 30032, United States

    SUITE 190

    DECATUR, GA 300335949

    Phone: (404) 299-9307

    Type: Mailing

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: 2008-10-25

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
I20081025000028IObstetrics/GynecologyGATBD

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 30087)

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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: 3476605841View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YGA
-GA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. GENESIS BOWEN (MD)'s NPI?
Yes. DR. GENESIS BOWEN (MD) is listed with NPI 1104805050 in the public NPI dataset.
Is DR. GENESIS BOWEN (MD) listed as active for patients and plans?
The listing shows DR. GENESIS BOWEN (MD) as active in the NPI system.
What healthcare role does DR. GENESIS BOWEN (MD) hold?
Scheduling teams often label DR. GENESIS BOWEN (MD) under Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where is DR. GENESIS BOWEN (MD) based?
DR. GENESIS BOWEN (MD) is tied to Stone Mountain, Georgia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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