Blake Bloomfield, PA-C
NPI 1063095743ActiveIndividual· Physician Assistant, Medical· Charlotte, NC
Physician Assistant, Medical (PA-C) in Charlotte, North Carolina, trained at Wake Forest University School of Medicine (class of 2025). Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1063095743 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Apr 30, 2021 |
| Last updated in NPPES | Jun 13, 2025 |
| Certified by provider | Jun 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
| Behavior Technician | 106S00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NC) |
|---|
Education and affiliations
| Medical school | Wake Forest University School of Medicine |
|---|---|
| Graduation year | 2025 |
| Medicare specialty | Physician Assistant |
Medical group
- Carolinas Medical CenterCharlotte, NC · 1,067 clinicians
Hospital affiliation
- Carolinas Medical Center/Behav HealthCharlotte, NC
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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