MAIN STREET MEDICAL CENTER
NPI 1619181914
Internal Medicine in Crestview, FL
About Main Street Medical Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAIN STREET MEDICAL CENTER (NPI 1619181914) is a healthcare organization registered as an internal medicine in Crestview, Florida and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through June 23, 2028 and lists Joshua K. Kolmetz, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted Insurance
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 Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Main Street Medical Center, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D1085687
Main Street Medical Center Of Crestview PA · Crestview, FLFrequently 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 Center Of Crestview, PA's NPI number?
The NPI number for Main Street Medical Center Of Crestview, PA is 1619181914. It was assigned to this organization in the NPPES registry on May 9, 2007. The provider is doing business as Main Street Medical Center.
Where is Main Street Medical Center Of Crestview, PA located?
Main Street Medical Center Of Crestview, PA is located at 369 N. Main St., Crestview, FL 32536. The listed phone number is (850) 398-6963.
What is Main Street Medical Center Of Crestview, PA's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Main Street Medical Center Of Crestview, PA enrolled in Medicare?
Yes. Main Street Medical Center Of Crestview, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Main Street Medical Center Of Crestview, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Main Street Medical Center Of Crestview, PA. 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 (6) and Internal Medicine (1). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Main Street Medical Center Of Crestview, PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D1085687) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Main Street Medical Center Of Crestview, PA accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Main Street Medical Center Of Crestview, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Main Street Medical Center Of Crestview, PA was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 Center · NPI 1619181914
Internal Medicine organization in Crestview, Florida. Organization record, active in the CMS NPPES registry since May 9, 2007.
## Identity
- **NPI:** 1619181914 (Entity type: Organization)
- **Enumerated:** May 9, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Main Street Medical Center Of Crestview, Pa
- **Organization subpart:** No
- **Authorized official:** Joshua Kolmetz, OWNER
## Practice location
- **Address:** 369 N. MAIN ST., Crestview, FL 32536-3541
- **Phone:** (850) 398-6963
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Internal Medicine (1); 6 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 21, 2018
- **Other identifiers:** Other A1315Z (FL); Other AI314 (FL); Other HR021Z (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619181914) · Data from the CMS NPPES public registry.