Individual provider Active NPI

Arnoldo N Chacon

  • Land Ambulance
  • Del Rio, TX
National Provider Identifier
1033532155
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
800145 Issued in TX
Practice address
3912 E Highway 90
Del Rio, TX 78840-8810
Phone
(830) 298-9796
NPI assigned
Jan 24, 2014
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 800145 TX Primary

Addresses

Primary practice location

3912 E Highway 90
Del Rio, TX 78840-8810

Mailing address

3912 E Highway 90
Del Rio, TX 78840-8810
Phone (830) 298-9796

Other identifiers 1

IdentifierTypeStateIssuer
182072201MedicaidTX

Other names 1

  • Amistad Ambulance Transports, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060911000221 TX Part B Supplier - Ambulance Service Supplier 9638173438 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Antonio, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
800145TXMDLand Ambulance

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1033532155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 E HIGHWAY 90",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788408810",
            "telephone_number": "830-298-9796",
            "fax_number": "830-298-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 E HIGHWAY 90",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788408810",
            "telephone_number": "830-298-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "ARNOLDO",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "800145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182072201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMISTAD",
            "last_name": "TRANSPORTS, LLC",
            "middle_name": "AMBULANCE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Del Rio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.