MELODY C BOLTON RUDI
NPI 1104588839
Anesthesiologist Assistant in Kennesaw, GA
About Melody C Bolton Rudi NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MELODY C BOLTON RUDI (NPI 1104588839) is an individual anesthesiologist assistant in Kennesaw, Georgia, licensed in Georgia (10618) and active in the NPI registry since October 2021. She is affiliated with Emory University Hospital and is a graduate of Emory University School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Melody C Bolton Rudi is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Melody Bolton Rudi reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Kennesaw, GA 30152
- Reassigned Medicare billing, Georgia enrollment
- 629 clinicians in this Medicare group
Atlanta, GA 30322
- Reassigned Medicare billing, Georgia enrollment
- 4,840 clinicians in this Medicare group
Lagrange, GA 30240
- Reassigned Medicare billing, Georgia enrollment
- 1,506 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Emory University Hospital
Acute Care Hospitals · Atlanta, GAEmory Decatur Hospital
Acute Care Hospitals · Decatur, GAMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KENNESAW, GA 30152
KENNESAW, GA 30152
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 Melody Bolton Rudi's NPI number?
The NPI number for Melody Bolton Rudi is 1104588839. It was assigned to this individual provider in the NPPES registry on October 11, 2021.
Where is Melody Bolton Rudi located?
Melody Bolton Rudi practices at 1300 Ridenour Blvd NW Ste 300, Kennesaw, GA 30152. The listed phone number is (985) 722-7993.
What is Melody Bolton Rudi's specialty?
The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.
Is Melody Bolton Rudi enrolled in Medicare?
Yes. Melody Bolton Rudi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Melody Bolton Rudi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Melody Bolton Rudi reassigns Medicare benefits to 3 organizations: Mak Anesthesia Holdings LLC (Kennesaw, GA), The Emory Clinic Inc (Atlanta, GA) and Emory Specialty Associates, LLC (Lagrange, GA). Each 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 Melody Bolton Rudi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Melody Bolton Rudi affiliated with any hospitals?
According to CMS data, Melody Bolton Rudi is affiliated with Emory University Hospital and Emory Decatur Hospital.
When was this NPI record last updated?
The NPPES record for Melody Bolton Rudi was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.
# Melody C Bolton Rudi · NPI 1104588839
Anesthesiologist Assistant physician in Kennesaw, Georgia. Individual provider, active in the CMS NPPES registry since October 11, 2021.
## Identity
- **NPI:** 1104588839 (Entity type: Individual)
- **Enumerated:** October 11, 2021
- **Primary specialty:** Anesthesiologist Assistant · taxonomy 367H00000X
- **State license:** 10618 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1300 RIDENOUR BLVD NW STE 300, Kennesaw, GA 30152-4402
- **Phone:** (985) 722-7993
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Mak Anesthesia Holdings LLC (NPI 1912452939, Kennesaw, GA); The Emory Clinic Inc (NPI 1396798229, Atlanta, GA); Emory Specialty Associates, LLC (NPI 1407864168, Lagrange, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Emory University School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** September 24, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1104588839) · Data from the CMS NPPES public registry.