GARY F BOULOUX (MD, DDS) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1750335733
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
67 MAXILLOFACIAL SURGERY in GA
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Provider Addresses for GARY F BOULOUX (MD, DDS)
Clifton Road Northeast, Candler Park, Druid Hills, DeKalb County, Georgia, 30329, United States
SUITE 2300
ATLANTA, GA 303221013
Phone: (404) 778-4500
Type: Mailing
Clifton Road Northeast, Emory Highlands, Druid Hills, DeKalb County, Georgia, 30329, United States
ATLANTA, GA 303221013
Phone: (404) 778-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $9,290.
Total Amount is formed as General ($9,290) + Research ($0) + Ownership ($0) = $9,290.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: ABBVIE INC. ($7,893).
Total Amount
$9,290
General + Research + Ownership
Payments
26
Total payment records
General Amount
$9,290
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $7,893 |
| Stryker Corporation | $921 |
| KLS-Martin L.P. | $476 |
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: 2006-07-11
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 |
|---|---|---|---|---|
| I20060711000340 | I | Maxillofacial Surgery | 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 |
|---|---|---|---|---|
| 70355 | X-ray of lower jaws, upper jaws and teeth | 97 | 87 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 57 | 57 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 37 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 12 | 11 | $0 |
Insurance plans in this area (ZIP 30322)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | CA | |
| Internal Medicine | GA | |
| Physician Assistant | FL | |
| Interventional Radiology, Diagnostic Radiology | KY | |
| Anesthesiology Assistant | GA | |
| - | CA | |
| D E R M A T O L O G Y | GA | |
| Interventional Radiology, Diagnostic Radiology | NC | |
| Physician Assistant | GA | |
| - | GA |
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