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MAIN STREET MEDICAL PROVIDERS LLC
NPI 1790497444
Internal Medicine in Parsippany, NJ

Active since December 14, 2022
65 LEAH WAY, PARSIPPANY, NJ 07054(551) 223-7912(646) 701-5598 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Main Street Medical Providers Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAIN STREET MEDICAL PROVIDERS LLC (NPI 1790497444) is a healthcare organization registered as an internal medicine in Parsippany, New Jersey and active in the NPI registry since December 2022. The organization lists Santhosh Chakilam, Owner, as its authorized official.

NPPES Registry Identity

NPI1790497444
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMAIN STREET MEDICAL PROVIDERS LLC
Location Address65 LEAH WAYParsippany, NJ 07054-3448
Mailing Address65 Leah WayParsippany, NJ 07054-3448 · (551) 223-7912 · Fax (646) 701-5598
Phone(551) 223-7912
Fax(646) 701-5598
Organization SubpartNo
Authorized OfficialSanthosh ChakilamOwner · (551) 223-7912
Enumeration DateDecember 14, 2022
NPPES CertifiedDecember 14, 2022
✔ NPI 1790497444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
65 LEAH WAY, Parsippany, NJ 07054
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Other Identifiers 1

Other25MA09915600NJ · License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Providers Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Main Street Medical Providers LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Santhosh Chakilam, M.D.
Internal Medicine
NPI 1184988628
1236 ROUTE 46 STE 100
Parsippany, NJ 07054
(551) 223-7912
✔ PECOS✔ Accepts Medicare1.0 mi
Rustica Atienza, APN
Nurse Practitioner
NPI 1538411830
1 CEDAR CREST VILLAGE DR
Pompton Plains, NJ 07444
(973) 831-3540
✔ PECOS✔ Accepts Medicare10.0 mi
Garfield Morgan
Nurse Practitioner
NPI 1861235665
362 BIRCH DR
Roselle, NJ 07203
(908) 590-4071
✔ PECOS✔ Accepts Medicare16 mi
Jeddie Garcia, APN
Nurse Practitioner
NPI 1457925364
11 HATAKAWANA TER
Budd Lake, NJ 07828
(973) 978-0174
✔ PECOS✔ Accepts Medicare17 mi
Renjini Basil
Nurse Practitioner
NPI 1790056182
202 HOWARD DRIVE APT # I
Bergenfield, NJ 07621
(201) 385-0538
✔ PECOS✔ Accepts Medicare22 mi

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 Providers LLC's NPI number?

The NPI number for Main Street Medical Providers LLC is 1790497444. It was assigned to this organization in the NPPES registry on December 14, 2022.

Where is Main Street Medical Providers LLC located?

Main Street Medical Providers LLC is located at 65 Leah Way, Parsippany, NJ 07054. The listed phone number is (551) 223-7912.

What is Main Street Medical Providers LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Main Street Medical Providers LLC enrolled in Medicare?

Yes. Main Street Medical Providers LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Main Street Medical Providers LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Main Street Medical Providers 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 (4) and Internal Medicine (1). Of these, 2 practice 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 Providers LLC was last updated on December 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.