Main Street Medical

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6216 Issued in CA

Legal business name

MAIN STREET MEDICAL

Practice address

799 Main St
Suite D
Half Moon Bay, CA 94019-1996

Phone

(650) 726-1200

Fax

(650) 726-1236

NPI assigned

Oct 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Pamela Celeste Carrington-Tribble, D.O.NPI 1174544027

Title

Physician/Owner

Phone

(650) 726-1200

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9057/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Celeste Carrington-Tribble, D.O

  • Family Medicine Physician
  • Meriden, CT
  • NPI 1174544027
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1023488970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 MAIN ST",
            "address_2": "SUITE D",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191996",
            "telephone_number": "650-726-1200",
            "fax_number": "650-726-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 MAIN ST",
            "address_2": "SUITE D",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191996",
            "telephone_number": "650-726-1200",
            "fax_number": "650-726-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "CARRINGTON-TRIBBLE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "CELESTE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "650-726-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humphrey H. Lu, MD
• Sergio Arturo Lua, M.A. LMFT
• Reyna Lubach, D.P.T.
• David Robert Maahs, DDS
• Raul Magallon Hernandez
• Mainstreet Medical Practice
• Vidur Malik
• Bradley Manning, PH.D.
• Edgar G Martinez
• Sonya Nanette Matthysse, RWP, NC

• Family Medicine Physician in Half Moon Bay, CA
• Providers in Half Moon Bay, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.