DR. RONDA BOUWENS (M.D.) – Family Medicine Physician, NPI 1104805134

DR. RONDA BOUWENS (M.D.) is a healthcare provider. based in Port angeles, Washington. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 61062895 (WA). The NPI Number for DR. RONDA BOUWENS (M.D.) is 1104805134

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. RONDA BOUWENS (M.D.)
NPI
1104805134
Phone
(360) 417-7000
Address
939 CAROLINE ST
Enumeration Date
9 January 2006
Last Update Date
5 June 2020

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3605650999
Graduation Year
1998 (28 years ago)
PAC ID
2062696768
Group Practice PAC ID
9537172358
Professional Enrollment ID
I20200428001627
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience82
Completeness75
Years active:20State licenses:3Digital endpointsOther names

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Provider Addresses for DR. RONDA BOUWENS (M.D.)

  • Olympic Medical Center, 939, Caroline Street, Port Angeles, Clallam County, Washington, 98362, United States

    PORT ANGELES, WA 983623909

    Phone: (360) 417-7000

    Mailing address matches the actual address.

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: 2023-02-22

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
I20230222002589IFamily PracticeAZTBD

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 98362)

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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: 9537172358View full group profile
NameSpecialtyState
Physician AssistantWA
-WA
Family PracticeWA
-NY
Emergency MedicineWA
-WA
-TN
H E M A T O L O G Y/ O N C O L O G YCA
Cardiovascular Disease (Cardiology)WA
Family PracticeGU

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. RONDA BOUWENS (M.D.)?
DR. RONDA BOUWENS (M.D.) — NPI 1104805134 — is the standard way to identify this listing.
Is DR. RONDA BOUWENS (M.D.) listed as active for patients and plans?
The listing shows DR. RONDA BOUWENS (M.D.) as active in the NPI system.
What is DR. RONDA BOUWENS (M.D.) best known for clinically?
Directory data describes DR. RONDA BOUWENS (M.D.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. RONDA BOUWENS (M.D.) on a map?
Expect Port Angeles, Washington as a primary anchor for DR. RONDA BOUWENS (M.D.) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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