DR. KENNETH L BOSS (MD) – Family Medicine Physician, NPI 1104891472
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,102 FAMILY PRACTICE in GA
Provider Addresses for DR. KENNETH L BOSS (MD)
705 Dallas Hwy
suite 101
Villa Rica, GA 301801247
Phone: (770) 456-4411
Fax: (770) 812-3582
Type: Location
1009 Alabama Ave S
Bremen, GA 301102501
Phone: (678) 821-6400
Type: Location
PO BOX 728
BREMEN, GA 301100728
Phone: (770) 537-1234
Type: Mailing
820 MAPLE ST
CARROLLTON, GA 301173626
Phone: (678) 390-7915
Type: Location
Ambulance Drive, Carrollton, Carroll County, Georgia, 30119, United States
SUITE 202
CARROLLTON, GA 301173857
Phone: (770) 838-8710
Type: Mailing
705, Dallas Highway, Villa Rica, Carroll County, Georgia, 30180, United States
SUITE 101
VILLA RICA, GA 301801247
Phone: (770) 456-4411
Fax: (770) 812-3582
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: 2005-09-20
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 |
|---|---|---|---|---|
| I20050920000311 | I | Family Practice | GA | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 184 | 27 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 146 | 145 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 109 | 54 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 91 | 90 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 53 | 53 | $0 |
Insurance plans in this area (ZIP 30180)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | GA | 83036 | Hemoglobin A1C level | 53 | 44 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NC | |
| Physician Assistant | GA | |
| Nurse Practitioner | FL | |
| Emergency Medicine, Family Practice | GA | |
| - | GA | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Family Practice | NJ | |
| - | GA | |
| Physician Assistant | GA |
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