DOROTHY BODUR (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063019040

DOROTHY BODUR (NP) is a healthcare provider. based in Indianapolis, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 28227920A (IN). The NPI Number for DOROTHY BODUR (NP) is 1063019040

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DOROTHY BODUR (NP)
NPI
1063019040
Phone
(574) 546-0330
Address
6720 PARKDALE PL
Enumeration Date
3 October 2020
Last Update Date
15 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8124018008
Graduation Year
2020 (6 years ago)
PAC ID
3678986700
Group Practice PAC ID
4587834874
Professional Enrollment ID
I20210111002171
Address ID
IN460382634FI10967RDXX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for DOROTHY BODUR (NP)

  • 6720 PARKDALE PL

    INDIANAPOLIS, IN 462544668

    Phone: (574) 546-0330

    Type: Mailing

  • 12687 WHITE CHAPEL CIR

    FISHERS, IN 460377401

    Phone: (812) 306-4478

    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: 2021-01-11

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210111002171INurse PractitionerINTBD

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 46254)

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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: 4587834874View full group profile
NameSpecialtyState
-IN
Clinical Social WorkerIN
Clinical Social WorkerIN
Clinical Social WorkerIN
Clinical Social WorkerIN
-IN
Clinical Social WorkerIN
Clinical Social WorkerIN
Mental Health CounselorIN
Clinical Social WorkerIN

Reviews

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Frequently asked questions

What number should I use to identify DOROTHY BODUR (NP) for billing?
Administrative and clinical systems typically use NPI 1063019040 for DOROTHY BODUR (NP).
Is DOROTHY BODUR (NP) currently accepting referrals based on NPI status?
Registry metadata lists DOROTHY BODUR (NP) as active.
Which specialty label fits DOROTHY BODUR (NP)?
NPPES ties DOROTHY BODUR (NP) to Psychiatric/Mental Health Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DOROTHY BODUR (NP)?
The directory associates DOROTHY BODUR (NP) with Indianapolis, Indiana. Check all listed addresses for suites or satellite offices.
Why is information missing for DOROTHY BODUR (NP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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