1. Home
  2. Directory
  3. Georgia
  4. Madison
  5. Clinic Center
  6. NPI Profile

BOULWARE P.A. INC
NPI 1073266292
Clinic/Center - Primary Care in Madison, GA

Active since January 28, 2022
216 N MAIN ST, MADISON, GA 30650(706) 343-4100 Get Directions Write a Review

NPPES record last updated: January 28, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Boulware P.a. Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULWARE P.A. INC (NPI 1073266292) is a healthcare organization registered as a primary care in Madison, Georgia and active in the NPI registry since January 2022. The organization lists Ronald Glen Boulware, Physician, as its authorized official.

NPPES Registry Identity

NPI1073266292
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBOULWARE P.A. INC
Location Address216 N MAIN STMadison, GA 30650-1313
Mailing AddressPo Box 788Madison, GA 30650-0788
Phone(706) 343-4100
Organization SubpartNo
Authorized OfficialRonald Glen BoulwarePhysician · (813) 546-0468
Enumeration DateJanuary 28, 2022
NPPES CertifiedJanuary 28, 2022
✔ NPI 1073266292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
216 N MAIN ST, Madison, GA 30650
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Boulware P.a. Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20220314001830Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Boulware P.A. Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ronald Boulware, MD
Family Practice
NPI 1033189469
216 N MAIN ST
Madison, GA 30650
(706) 343-4100
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulware P.A. Inc's NPI number?

The NPI number for Boulware P.A. Inc is 1073266292. It was assigned to this organization in the NPPES registry on January 28, 2022.

Where is Boulware P.A. Inc located?

Boulware P.A. Inc is located at 216 N Main St, Madison, GA 30650. The listed phone number is (706) 343-4100.

What is Boulware P.A. Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Boulware P.A. Inc enrolled in Medicare?

Yes. Boulware P.A. Inc is registered in the Medicare PECOS enrollment system.

When is Boulware P.A. Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Boulware P.A. Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Boulware P.A. Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Boulware P.A. Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Boulware P.A. Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Boulware P.A. Inc was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.