MARK GORDON BODDY (MD) – Maternal & Fetal Medicine Physician, NPI 1518059880
Maternal & Fetal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MARK GORDON BODDY (MD)
840 Pine St
Suite 990
Macon, GA 312012100
Phone: (478) 738-0404
Fax: (478) 738-0805
Type: Location
840, Pine Street, Macon, Bibb County, Georgia, 31201, United States
SUITE 990
MACON, GA 312012100
Phone: (478) 738-0404
Fax: (478) 738-0805
Type: Location
Stanford Hospital, 300, Pasteur Drive, Stanford, Palo Alto, Santa Clara County, California, 94305, United States
STANFORD, CA 943052200
Phone: (831) 759-3265
Type: Mailing
725 WELCH RD
PALO ALTO, CA 943041601
Phone: (650) 497-8000
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: 2012-12-06
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 |
|---|---|---|---|---|
| I20121206000281 | I | Obstetrics/Gynecology | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| - | CA | |
| - | CA | |
| Clinical Psychologist | CA | |
| Diagnostic Radiology | CO | |
| - | CA |
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