MAIN STREET MEDICAL CENTER
NPI 1619181914
Internal Medicine in Crestview, FL
NPI Status: Active since May 09, 2007
Contact Information
369 N. MAIN ST.
CRESTVIEW, FL
ZIP 32536
Phone: (850) 398-6963
- Organization
- Internal Medicine
- CLIA Number: 10D1085687
- CLIA Cert. Type: Mobile Laboratory
- CLIA Exp. Date: 06-23-2026
About MAIN STREET MEDICAL CENTER
This page provides the complete NPI Profile along with additional information for Main Street Medical Center, an internist established in Crestview, Florida operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1619181914 assigned on May 2007. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Main Street Medical Center operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Main Street Medical Center. The authorized official of this NPI record is Joshua K. Kolmetz Md (Owner)
- NPI
- 1619181914
- Provider Legal Name
- MAIN STREET MEDICAL CENTER OF CRESTVIEW, PA
- Other Organization Name
- MAIN STREET MEDICAL CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 369 N. MAIN ST. CRESTVIEW, FL 32536
- Location Phone
- (850) 398-6963
- Mailing Address
- 369 N. MAIN ST. CRESTVIEW, FL 32536
- Mailing Phone
- (850) 398-6963
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-09-2007
- Last Update Date
- 06-21-2018
- Code Navigator
An internist like Main Street Medical Center is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| A1315Z | OTHER (01) | FL | INDIVIDUAL PROVIDER MEDICARE PTAN |
| AI314 | OTHER (01) | FL | MEDICARE GROUP PTAN |
| ========= | OTHER (01) | FL | TN |
| HR021Z | OTHER (01) | FL | INDIVIDUAL PROVIDER PTAN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D1085687
- Facility Type
- Mobile Laboratory
- Certificate Effective Date
- June 24, 2024
- Certificate Expiration Date
- June 23, 2026
- Laboratory Director
- JOSHUA K. KOLMETZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Main Street Medical Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 1 | 9 | 1 | 8 | 1 | 9 | 1 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 2 | 9 | 2 | 8 | 2 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 2 + 9 + 2 + 8 + 2 + 9 + 2 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1619181914 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619181914, enumerated in the NPI registry as an "organization" on May 09, 2007
The provider is located at 369 N. Main St. Crestview, Fl 32536 and the phone number is (850) 398-6963
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D1085687 for a "mobile laboratory" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on May 09, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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