| Main Street Medical Group, Llc | |
|
7190 Cottesmore Ln Solon OH 44139-4702 | |
| (440) 349-1983 | |
| (440) 349-1983 |
| Full Name | Main Street Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7190 Cottesmore Ln, Solon, Ohio |
| Authorized Official Name and Position | Randall Scott Schwartz (PROPRIETOR) |
| Authorized Official Contact | 4409464662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Medical Group, Llc 36001 Euclid Ave C-17 Willoughby OH 44094-4643 Ph: (440) 946-4662 | Main Street Medical Group, Llc 7190 Cottesmore Ln Solon OH 44139-4702 Ph: (440) 349-1983 |
| NPI Number | 1063683662 |
|---|---|
| Provider Enumeration Date | 03/21/2008 |
| Last Update Date | 08/18/2023 |
| Medicare PECOS PAC ID | 5597835728 |
|---|---|
| Medicare Enrollment ID | O20080530000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063683662 | NPI | - | NPPES |
| 2817321 | Medicaid | OH | |
| 000000562822 | Other | OH | ANTHEM BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-06-0015 (Ohio) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Dolores A Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801849005 PECOS PAC ID: 0446147557 Enrollment ID: I20040303000440 |
| Provider Name | Randall S Schwartz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629093729 PECOS PAC ID: 0244334936 Enrollment ID: I20080530000499 |
| Provider Name | Matthew Dvorak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578977518 PECOS PAC ID: 5890013296 Enrollment ID: I20180718003573 |
| Provider Name | Yelena Bogatello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407198914 PECOS PAC ID: 4385887256 Enrollment ID: I20201016001747 |
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Community Hospitalists Of Pennsylvania, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30680 Bainbridge Rd, Solon, OH 44139 Phone: 440-542-5023 Fax: 440-542-5029 | |
Family Care Centers Of Ohio Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30680 Bainbridge Rd, Solon, OH 44139 Phone: 440-542-5000 Fax: 440-542-5029 | |
Neo Total Health And Wellness, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5855 Harper Rd Ste A, Solon, OH 44139 Phone: 440-592-6105 | |
Pat Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30680 Bainbridge Rd, Solon, OH 44139 Phone: 440-542-5023 Fax: 440-542-5029 | |
Community Hospitalist, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30680 Bainbridge Rd, Solon, OH 44139 Phone: 440-542-5023 Fax: 440-542-5029 |