MAIN STREET MEDICAL CENTERS – Primary Care Clinic/Center, NPI 1487079505
Primary Care Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MAIN STREET MEDICAL CENTERS
PO BOX 17175
TAMPA, FL 336827175
Phone: (813) 220-1400
Fax: (813) 341-4004
Type: Mailing
10549 N FLORIDA AVE STE I
TAMPA, FL 336126707
Phone: (813) 220-1400
Type: Location
6506 Embassy Blvd
Port Richey, FL 346684734
Phone: (727) 387-8228
Fax: (727) 387-8020
Type: Location
10549 N FLORIDA AVE STE A
TAMPA, FL 336126707
Phone: (813) 220-1400
Fax: (813) 440-6484
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (101 days ago).
Enrollment records
1
Earliest due date
2026-02-28
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190729000315 | O | Clinic/Group Practice | FL | 2026-02-28 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33682)
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