MAIN STREET MEDICAL GROUP, LLC (NPI# 1063683662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063683662 |
Entity Type | Organization |
Organization Name | MAIN STREET MEDICAL GROUP, LLC |
Practice Address |
36001 Euclid Ave C-17 Willoughby OH 44094-4643 |
Practice Telephone | 4409464662 |
Practice Fax Number | 4409464084 |
Mailing Telephone | 4409464662 |
Mailing Fax Number | 4409464084 |
Enumeration Date | 2008-03-21 |
Last Update Date | 2008-09-20 |
Authorized Official Name | DR. RANDALL SCOTT SCHWARTZ (PROPRIETOR) |
Authorized Official Telephone | 4409464662 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | 35-06-0015 | OH | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 2817321 | 05 | |
OH | ANTHEM BLUE SHIELD | 000000562822 | 01 |
Street Address |
36001 EUCLID AVE C-17 |
City | WILLOUGHBY |
State | OH |
Zip Code | 44094-4643 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013907989 | Ming Huei Phillip Chiang | Family Medicine | 36001 Euclid Ave, B4, Willoughby, OH 44094-4643 | 2005-10-24 |
1992306633 | Alisha Howland | Nurse Practitioner | 36001 Euclid Ave, Willoughby, OH 44094-4643 | 2020-11-07 |
1699140202 | Phillip W Wallace Dds Inc | Dentist | 36001 Euclid Ave, Suite A-15, Willoughby, OH 44094-4643 | 2015-12-08 |
1366787624 | Anthony James Lorenzo | Acupuncturist | 36001 Euclid Ave, Suite A-6, Willoughby, OH 44094-4643 | 2012-11-27 |
1447542790 | Austin Charles Homrighaus | Acupuncturist | 36001 Euclid Ave, Suite B-7, Willoughby, OH 44094-4643 | 2011-05-04 |
1336464528 | Enlightened Health Management LLC | Pain Medicine | 36001 Euclid Ave, Willoughby, OH 44094-4643 | 2010-03-31 |
1124255278 | Lake Hospital System, Inc. | Surgery | 36001 Euclid Ave, B-3, Willoughby, OH 44094-4643 | 2009-06-16 |
1134314644 | Russell Allen Blair | Internal Medicine | 36001 Euclid Ave, C19, Willoughby, OH 44094-4643 | 2007-09-07 |
1295929792 | Jennifer L Kriessler | Nurse Practitioner | 36001 Euclid Ave, C6, Willoughby, OH 44094-4643 | 2007-08-29 |
1871798801 | M H Phillip Chiang Md Inc | Family Medicine | 36001 Euclid Ave, B 4, Willoughby, OH 44094-4643 | 2007-06-19 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
Find all providers in zip 44094 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
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. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619234689 | John William Horinger Jr. | Internal Medicine | 36100 Euclid Ave Ste 240, Willoughby, OH 44094-4427 | 2012-04-16 |
1427291061 | Adriatik Kellici | Internal Medicine | 38582 Heritage Ct, Willoughby, OH 44094-8839 | 2009-04-13 |
1164697629 | Lake Hospital System Inc | Internal Medicine | 2747 Som Center Rd, Willoughby, OH 44094-9164 | 2008-04-25 |
1356566848 | Joel Stuart Steinberg | Internal Medicine | 5370 Som Center Rd, Willoughby, OH 44094-4208 | 2007-04-17 |
1306967807 | Drs Byers & Birnbaum Inc | Internal Medicine | 35040 Chardon Rd Ste G200, Willoughby, OH 44094-9055 | 2007-04-02 |
1982782363 | Dawn Renee Joseph | Internal Medicine | 5105 Som Center Rd., Kaiser Permanente, Willoughby, OH 44094 | 2006-11-01 |
1487750477 | Marinela L Turc | Internal Medicine | 36001 Euclid Ave Ste B11, Willoughby, OH 44094-4651 | 2006-09-16 |
1861508103 | Robert T. Mulcahy | Internal Medicine | 36100 Euclid Avenue #240, Willoughby, OH 44094 | 2006-08-21 |
1144756248 | Jennifer Ashley Bostick | Internal Medicine | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2017-05-10 |
1861928962 | Andrew Bostick | Internal Medicine | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2017-05-10 |
Find all providers in WILLOUGHBY |
City | WILLOUGHBY |
Zip Code | 44094 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.