TRACY D BLAND DUBOSE (MD) – Obstetrics & Gynecology Physician, NPI 1952395535

TRACY D BLAND DUBOSE (MD) is a healthcare provider. based in Lithonia, Georgia. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 052865 (GA). The NPI Number for TRACY D BLAND DUBOSE (MD) is 1952395535

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
TRACY D BLAND DUBOSE (MD)
NPI
1952395535
Phone
(770) 322-2716
Address
5440 HILLANDALE DRIVE
Enumeration Date
9 September 2005
Last Update Date
13 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
4043647206
Graduation Year
1999 (27 years ago)
PAC ID
2769560549
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20080418000357
Address ID
GA303051729AT3495XNEXX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,266 OBSTETRICS/GYNECOLOGY in GA

Provider Addresses for TRACY D BLAND DUBOSE (MD)

  • 5440 HILLANDALE DRIVE

    DEPARTMENT OF OB GYN

    LITHONIA, GA 30058

    Phone: (770) 322-2716

    Fax: (770) 322-3244

    Type: Location

  • Piedmont 9, 3495, Piedmont Road Northeast, Buckhead, Atlanta, Fulton County, Georgia, 30305, United States

    NINE PIEDMONT CENTER

    ATLANTA, GA 30305

    Phone: (404) 364-7000

    Fax: (404) 364-4732

    Type: Mailing

  • 3495 PIEDMONT RD NE

    NINE PIEDMONT CENTER

    ATLANTA, GA 303051717

    Phone: (404) 364-7000

    Fax: (404) 364-4732

    Type: Mailing

  • 5440 HILLANDALE DR

    DEPARTMENT OF OB GYN

    LITHONIA, GA 300584865

    Phone: (770) 322-2716

    Fax: (770) 322-3244

    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: 2008-04-18

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
I20080418000357IObstetrics/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 30058)

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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: 6204829013View full group profile

Reviews

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Frequently asked questions

What identifier follows TRACY D BLAND DUBOSE (MD) across health systems?
The NPI 1952395535 uniquely identifies TRACY D BLAND DUBOSE (MD) in U.S. healthcare data.
Should I treat TRACY D BLAND DUBOSE (MD) as an active provider?
Patients and plans typically see TRACY D BLAND DUBOSE (MD) as active in the national extract.
What does the directory say TRACY D BLAND DUBOSE (MD) does?
Insurance directories may phrase it differently, but here TRACY D BLAND DUBOSE (MD) maps to Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Is TRACY D BLAND DUBOSE (MD) tied to Lithonia, Georgia?
If you are local to Lithonia, Georgia, TRACY D BLAND DUBOSE (MD) may be relevant to your search.
Can I export TRACY D BLAND DUBOSE (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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