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DR. PHANI BODAVULA M.D.
NPI 1700204690
Pediatrics in Garland, TX

Active since March 28, 2014PECOS Enrolled
6448 BROADWAY BLVD, GARLAND, TX 75043(972) 216-8500(972) 216-8521 Get Directions Write a Review

NPPES record last updated: September 20, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 20, 2025, Jul 21, 2022, Aug 5, 2021 and 3 more (6 updates tracked since 2017).

About Dr. Phani Bodavula M.d. NPPES

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

DR. PHANI BODAVULA M.D. (NPI 1700204690) is an individual pediatrics provider in Garland, Texas, licensed in Texas (R5085) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700204690
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. PHANI BODAVULACredential: M.D.
Location Address6448 BROADWAY BLVDGarland, TX 75043
Mailing Address6448 Broadway BlvdGarland, TX 75043-5943 · (972) 216-8500 · Fax (972) 216-8521
Phone(972) 216-8500
Fax(972) 216-8521
Sole ProprietorNo
Enumeration DateMarch 28, 2014
Last NPPES UpdateSeptember 20, 20256 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2025
✔ NPI 1700204690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · R5085
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
6448 BROADWAY BLVD, Garland, TX 75043
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Cigna Healthcare, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Phani Bodavula M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Phani Bodavula reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Medical College Of Wisconsin, Inc.
844 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101
Ascension Medical Group-Southeast Wisconsin Inc
850 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75043 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JYOTI JAIN, MD, PA
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
BODAVULA PEDIATRICS PLLC
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
NORTH DALLAS PEDIATRICS ASSOCIATES PC
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
SREEVANI BODAVULA APRN, FNP-C
Nurse Practitioner (Family)
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
DR. JYOTI JAIN M.D.
Pediatrics (Adolescent Medicine)
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500

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 Phani Bodavula's NPI number?

The NPI number for Phani Bodavula is 1700204690. It was assigned to this individual provider in the NPPES registry on March 28, 2014.

Where is Phani Bodavula located?

Phani Bodavula practices at 6448 Broadway Blvd, Garland, TX 75043. The listed phone number is (972) 216-8500.

What is Phani Bodavula's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Phani Bodavula enrolled in Medicare?

Yes. Phani Bodavula is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Phani Bodavula's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phani Bodavula reassigns Medicare benefits to 2 organizations: The Medical College Of Wisconsin, Inc. (Milwaukee, WI) and Ascension Medical Group-Southeast Wisconsin Inc (Milwaukee, WI). 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 Phani Bodavula's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Phani Bodavula accept?

Health plans from Blue Cross and Blue Shield of Texas, Cigna Healthcare, Oscar Insurance Company and UnitedHealthcare list Phani Bodavula 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 Phani Bodavula was last updated on September 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.