St. Mark Medical Transport LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

ST. MARK MEDICAL TRANSPORT LLC

Practice address

207 S Maple Ave
South San Francisco, CA 94080-6305

Phone

(650) 880-2588

NPI assigned

Oct 27, 2022

Organization subpart

Yes

Parent organization

CAREGENTUM INC.As reported in NPPES

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

Authorized official

Name

Mark Victor Ignacio

Title

Owner/Ceo

Phone

(650) 483-2169

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740268800000",
    "number": "1003523275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD STE 521",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152631",
            "telephone_number": "650-483-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S MAPLE AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940806305",
            "telephone_number": "650-880-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARK MEDICAL TRANSPORT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAREGENTUM INC.",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-02-23",
        "certification_date": "2025-02-23",
        "status": "A",
        "authorized_official_last_name": "IGNACIO",
        "authorized_official_first_name": "MARK VICTOR",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "650-483-2169"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South San Francisco Fire Dept
• South San Francisco Usd
• Matthew James Sowiski
• Speech Goals Speech Therapy Inc.
• St. Mark Ambulance LLC
• Diane Stanton
• Statcare Recruiting
• Stephanie Home Inc.
• Stephanie Lily Home Inc.
• Douglas Russell Stewart, MD

• Ambulance in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.