MAIN MEDICAL-MYSTIC, LLC
NPI 1003001850
Internal Medicine in Mystic, CT

NPI Status: Active since September 13, 2007

Contact Information

23 CLARA DR
SUITE 201
MYSTIC, CT
ZIP 06355
Phone: (860) 536-1666
Fax: (860) 536-9770

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  • Organization
  • Internal Medicine

About MAIN MEDICAL-MYSTIC, LLC

Main Medical-mystic, Llc is an internist established in Mystic, Connecticut operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1003001850 assigned on September 2007. The practitioner's primary taxonomy code is 207R00000X with license number 031865 (CT). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Roy Martin Main M.d. (Owner/physician)

NPI
1003001850
Provider Name
MAIN MEDICAL-MYSTIC, LLC
Entity Type
Organization
Location Address
23 CLARA DR SUITE 201 MYSTIC, CT 06355
Location Phone
(860) 536-1666
Location Fax
(860) 536-9770
Mailing Address
23 CLARA DR SUITE 201 MYSTIC, CT 06355
Mailing Phone
(860) 536-1666
Mailing Fax
(860) 536-9770
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-13-2007
Last Update Date
09-13-2007
Code Navigator

An internist like Main Medical-mystic, Llc 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.

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
License No.
031865
License State
CT
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 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ROY MARTIN MAIN M.D.

Authorized Official Title
OWNER/PHYSICIAN
Authorized Official Phone
(860) 536-1666

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
C02861MEDICARE PIN (08)CT 
B30093MEDICARE UPIN (02)CT 

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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.
1003001850
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003002810
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 2 + 8 + 1 + 0 + 24 = 40
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003001850 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1720065154 BRUCE A. BERLOW M.D.
Individual
Specialist23 CLARA DR SUITE 204
MYSTIC, CT 06355
(860) 536-2995
1265656946 JENNIFER FELICELLI PA-C
Individual
Physician Assistant23 CLARA DR
MYSTIC, CT 06355
(860) 536-1666
1013195064MRS. LAURA ANN WHITE OTRL
Individual
Occupational Therapist23 CLARA DR VISIONS SIGHT AND LEARNING CENTER
MYSTIC, CT 06355
(860) 572-4805
1528236932MRS. GABRIELLE EDEN PIERCE PA-C
Individual
Physician Assistant23 CLARA DR SUITE 201
MYSTIC, CT 06355
(860) 536-1666
1467659227DR. ADRIENNE LYNNE MAROLD PARAD M.D.
Individual
Family Medicine23 CLARA DR SUITE 203
MYSTIC, CT 06355
(860) 464-2028
1558406066 DANIEL LEROY WAGGONER M.D.
Individual
Allergy & Immunology23 CLARA DR SUITE 204
MYSTIC, CT 06355
(860) 536-2995
1811109259COASTAL CHIROPRACTIC & FAMILY WELLNESS CENTRE
Organization
Chiropractor (Rehabilitation)23 CLARA DR SUITE 105
MYSTIC, CT 06355
(860) 572-7711
1891417242 DANIELLE PETROWSKI
Individual
Nurse Practitioner (Family)23 CLARA DR
MYSTIC, CT 06355
(860) 572-5782
1437611696DR. SUNGSIL CHO MD
Individual
Family Medicine23 CLARA DR
MYSTIC, CT 06355
(860) 572-5782

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003001850, enumerated in the NPI registry as an "organization" on September 13, 2007

The provider is located at 23 Clara Dr Suite 201 Mystic, Ct 06355 and the phone number is (860) 536-1666

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.

This NPI record was last updated on September 13, 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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