The Bortolazzo Group, LLC
NPI 1801965082ActiveOrganization· Emergency Medicine· Austell, GA
Emergency Medicine in Austell, Georgia, registered in NPPES in November 2006. The authorized official on file is Kim H. Larsen, Director Of Credentialing. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801965082 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 6, 2006 |
| Last updated in NPPES | Feb 5, 2020 |
| Certified by provider | Feb 5, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Emergency Medicine Primary | 207P00000X | — | — |
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 Part B Supplier - Clinic/Group Practice (GA) |
|---|
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