South Main Medical Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTH MAIN MEDICAL ASSOCIATES, LLC

Practice address

1317 S Main Rd
Suite 2 C
Vineland, NJ 08360-6511

Phone

(856) 213-6080

Fax

(856) 213-6092

NPI assigned

Jul 5, 2011

Last updated

Jul 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Olga Kaczaj, M.D.NPI 1518055755

Title

Owner

Phone

(856) 213-6080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: southmainmedical@smm.azalea.phimailbox.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olga Kaczaj, M.D.

  • Internal Medicine Physician
  • Vineland, NJ
  • NPI 1518055755
  Medicare reassignment Care Compare group NPD Authorized official
• Natalie A Ramos, APN

  • Nurse Practitioner
  • Vineland, NJ
  • NPI 1720866361
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1346537917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 S MAIN RD",
            "address_2": "SUITE 2 C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606511",
            "telephone_number": "856-213-6080",
            "fax_number": "856-213-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 S MAIN RD",
            "address_2": "SUITE 2 C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606511",
            "telephone_number": "856-213-6080",
            "fax_number": "856-213-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MAIN MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "KACZAJ",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-213-6080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Jersey Pediatric Dental, LLC
• South Jersey Radiation Oncology P.C.
• South Jersey Surgicenter, Inc
• South Jersey Urgicare LLC (Vineland Urgent Care)
• South Jersey Urology Consultants LLC
• Southern Oncology Hematology Assoc
• Southern Regional Pathology Associates, PC
• Anthony J Spadano, RN
• Scott Evan Spagnolo-Hye, D.O.
• Rachel Dawn Spayd, DO

• Internal Medicine Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.