THE BORTOLAZZO GROUP, LLC
NPI 1801965082
Emergency Medicine in Austell, GA
About The Bortolazzo Group, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE BORTOLAZZO GROUP, LLC (NPI 1801965082) is a healthcare organization registered as an emergency medicine in Austell, Georgia and active in the NPI registry since November 2006. The organization maintains 3 additional practice locations and lists Kim H Larsen, Director Of Credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Bortolazzo Group, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
351Medicare enrollment records show 351 clinicians reassign Medicare billing to The Bortolazzo Group, LLC, which bills Medicare for the services they deliver. Of these, 30 practice at this address and 77 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 351Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 The Bortolazzo Group, LLC's NPI number?
The NPI number for The Bortolazzo Group, LLC is 1801965082. It was assigned to this organization in the NPPES registry on November 6, 2006.
Where is The Bortolazzo Group, LLC located?
The Bortolazzo Group, LLC is located at 3950 Austell Rd, Austell, GA 30106. The listed phone number is (770) 732-4000.
What is The Bortolazzo Group, LLC's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is The Bortolazzo Group, LLC enrolled in Medicare?
Yes. The Bortolazzo Group, LLC is registered in the Medicare PECOS enrollment system.
When is The Bortolazzo Group, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through The Bortolazzo Group, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 351 clinicians in 6 Medicare specialties reassign their Medicare billing to The Bortolazzo Group, LLC. A 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 the clinician's services. The largest specialties are Emergency Medicine (254), Nurse Practitioner (86) and Pediatric Medicine (8). Of these, 30 practice at this address and 77 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does The Bortolazzo Group, LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list The Bortolazzo Group, LLC 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 The Bortolazzo Group, LLC was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# The Bortolazzo Group, Llc · NPI 1801965082
Emergency Medicine organization in Austell, Georgia. Organization record, active in the CMS NPPES registry since November 6, 2006.
## Identity
- **NPI:** 1801965082 (Entity type: Organization)
- **Enumerated:** November 6, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **Organization subpart:** No
- **Authorized official:** Kim Larsen, DIRECTOR OF CREDENTIALING
## Practice location
- **Address:** 3950 AUSTELL RD, Austell, GA 30106-1121
- **Phone:** (770) 732-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 351 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Emergency Medicine (254), Nurse Practitioner (86), Pediatric Medicine (8); 30 practice at this address and 77 within 10 miles; [full list](https://npiprofile.com/npi/1801965082/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 5, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1801965082) · Data from the CMS NPPES public registry.