Organization Active NPI

Central Islip-Hauppauge Volunteer Ambulance, Inc.

  • Land Ambulance
  • Central Islip, NY
National Provider Identifier
1093284499
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CENTRAL ISLIP-HAUPPAUGE VOLUNTEER AMBULANCE, INC.
Practice address
4 Pineville Road
Central Islip, NY 11722-2311
Phone
(631) 582-4414
Fax
(631) 582-2615
NPI assigned
Nov 15, 2018
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Paul V. Ryan
Title
Board Chairman
Phone
(631) 582-4414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NU Primary

Addresses

Primary practice location

4 Pineville Road
Central Islip, NY 11722-2311

Mailing address

4 Pineville Rd
Central Islip, NY 11722-2311
Phone (631) 582-4414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190107002724 NY Part B Supplier - Ambulance Service Supplier 5991041352 Practice locations: Central Islip, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2291066Central Islip - Hauppauge Volunteer4 Pineville Rd, Central Islip, NY 11722Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

4 Pineville Rd
Central Islip, NY 11722
Phone (631) 582-4414

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1093284499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PINEVILLE RD",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222311",
            "telephone_number": "631-582-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PINEVILLE ROAD",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222311",
            "telephone_number": "631-582-4414",
            "fax_number": "631-582-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ISLIP-HAUPPAUGE VOLUNTEER AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "631-582-4414"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.