Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLAKE LEE BERTOLINO
NPI 1477136711
Psychiatry & Neurology - Neurology in Charlotte, NC

Q: What is Blake Bertolino's NPI number?

The NPI number for Blake Bertolino is 1477136711. It was assigned to this individual provider in the NPPES registry on May 4, 2021.

Q: What is Blake Bertolino's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Blake Bertolino was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 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.

Active since May 04, 2021PECOS Enrolled

6324 FAIRVIEW RD STE 400, CHARLOTTE, NC 28210(406) 281-1173 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2026, Jul 15, 2026, May 4, 2021 (3 updates tracked since 2021).

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About Blake Lee Bertolino NPPES

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

BLAKE LEE BERTOLINO (NPI 1477136711) is an individual neurology provider in Charlotte, North Carolina, licensed in North Carolina (2026-04025) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477136711

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameBLAKE LEE BERTOLINO

Location Address6324 FAIRVIEW RD STE 400Charlotte, NC 28210-4278

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(406) 281-1173

Sole ProprietorYes

Enumeration DateMay 4, 2021

Last NPPES UpdateJuly 21, 20263 updates tracked since enumeration

NPPES CertifiedJuly 21, 2026

✔ NPI 1477136711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in NC · 2026-04025

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

6324 FAIRVIEW RD STE 400, Charlotte, NC 28210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blake Lee Bertolino 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28210 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 6

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

NOVANT MEDICAL GROUP, INC.

Internal Medicine (Cardiovascular Disease)