MAIN STREET MEDICAL CENTERS
NPI 1487079505
Clinic/Center - Primary Care in Tampa, FL
About Main Street Medical Centers NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAIN STREET MEDICAL CENTERS (NPI 1487079505) is a healthcare organization registered as a primary care in Tampa, Florida and active in the NPI registry since February 2014. The organization maintains a secondary practice location in Port Richey and lists Stephen O Banjoko, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Names 1
Secondary Practice Location 1
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Main Street Medical Centers is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Main Street Medical Centers, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: 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 Main Street Medical LLC's NPI number?
The NPI number for Main Street Medical LLC is 1487079505. It was assigned to this organization in the NPPES registry on February 26, 2014. The provider is doing business as Main Street Medical Centers.
Where is Main Street Medical LLC located?
Main Street Medical LLC is located at 10549 N Florida Ave Ste A, Tampa, FL 33612. The listed phone number is (813) 220-1400.
What is Main Street Medical LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Main Street Medical LLC enrolled in Medicare?
Yes. Main Street Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Main Street Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Main Street Medical 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 Nurse Practitioner (3), Family Practice (2) and Internal Medicine (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Main Street Medical LLC was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Main Street Medical Centers · NPI 1487079505
Primary Care organization in Tampa, Florida. Organization record, active in the CMS NPPES registry since February 26, 2014.
## Identity
- **NPI:** 1487079505 (Entity type: Organization)
- **Enumerated:** February 26, 2014
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Main Street Medical Llc
- **Organization subpart:** No
- **Authorized official:** Stephen Banjoko, CFO
## Practice location
- **Address:** 10549 N FLORIDA AVE STE A, Tampa, FL 33612-6707
- **Phone:** (813) 220-1400 · **Fax:** (813) 440-6484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (2), Internal Medicine (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 3, 2024
- **Other identifiers:** Medicaid 104624600 (FL); Other LK078 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1487079505) · Data from the CMS NPPES public registry.