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DR. GOUTHAMI BODDU MD
NPI 1972173011
Internal Medicine in Fayetteville, NC

Active since June 30, 2021PECOS EnrolledAccepts Medicare Assignment
1638 OWEN DR, FAYETTEVILLE, NC 28304(910) 615-4000 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 18, 2025, Aug 1, 2024, Jun 30, 2021 (3 updates tracked since 2021).

About Dr. Gouthami Boddu Md NPPES

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

DR. GOUTHAMI BODDU MD (NPI 1972173011) is an individual internal medicine provider in Fayetteville, North Carolina, licensed in North Carolina (2024-01318) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Cape Fear Valley Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1972173011
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. GOUTHAMI BODDUCredential: MD
Location Address1638 OWEN DRFayetteville, NC 28304-3424
Mailing Address1638 Owen DrFayetteville, NC 28304-3424 · (910) 615-4000
Phone(910) 615-4000
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJune 30, 2021
Last NPPES UpdateJune 18, 20253 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
✔ NPI 1972173011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 2024-01318
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1638 OWEN DR, Fayetteville, NC 28304
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1210 Medical Pavilion DrRaeford, NC 28376-9111 · Phone (910) 904-8000
Location 2501 S Poplar StElizabethtown, NC 28337-9375 · Phone (910) 862-5100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

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

Dr. Gouthami Boddu Md 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.

PECOS PAC ID4385176197
PECOS Enrollment IDI20241017004230
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 Gouthami Boddu reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cumberland County Hospital System Inc
Same address
Nurse Practitioner
1638 OWEN DR
Fayetteville, NC 28304
  • Reassigned Medicare billing, North Carolina enrollment
  • 906 clinicians in this Medicare group
NPI 1063964708 (910) 615-5490
Bladen Healthcare, LLC
28 mi
Rural Health
16 3RD ST
Dublin, NC 28332
  • Reassigned Medicare billing, North Carolina enrollment
  • 170 clinicians in this Medicare group
NPI 1114193695 (910) 862-3528

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
219 services75 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
62 services60 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cape Fear Valley Medical Center

Acute Care Hospitals · Fayetteville, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340028
Location1638 Owen Drive P O Box 2000Fayetteville, NC 28302 · Cumberland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28304 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 20

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

MR. KEVIN TRAVIS WORTH CRNA
Nurse Anesthetist, Certified Registered
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000
HEATHER MCPHAIL COAXUM NP
Nurse Practitioner (Family)
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-5680
CAPE FEAR VALLEY MEDICAL CENTER
Pharmacist
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-7968
WENDY LYNN BROCK NNP
Nurse Practitioner
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-5490
ABHISHEK GOEL MD
Hospitalist
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3960
LAUREN WOHLRAB
Student in an Organized Health Care Education/Training Program
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 609-5000
DR. OMAIR MOHAMED
Student in an Organized Health Care Education/Training Program
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3780
JINGCHUAN WANG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000

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 Gouthami Boddu's NPI number?

The NPI number for Gouthami Boddu is 1972173011. It was assigned to this individual provider in the NPPES registry on June 30, 2021.

Where is Gouthami Boddu located?

Gouthami Boddu practices at 1638 Owen Dr, Fayetteville, NC 28304. The listed phone number is (910) 615-4000.

What is Gouthami Boddu's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Gouthami Boddu enrolled in Medicare?

Yes. Gouthami Boddu 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 Gouthami Boddu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gouthami Boddu reassigns Medicare benefits to 2 organizations: Cumberland County Hospital System Inc (Fayetteville, NC) and Bladen Healthcare, LLC (Dublin, NC). 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 Gouthami Boddu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gouthami Boddu accept?

Health plans from Cigna Healthcare list Gouthami Boddu 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.

Is Gouthami Boddu affiliated with any hospitals?

According to CMS data, Gouthami Boddu is affiliated with Cape Fear Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Gouthami Boddu was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.