Organization Active NPI

Village of Northport

  • Land Ambulance
  • Northport, NY
National Provider Identifier
1104782317
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
VILLAGE OF NORTHPORT
Practice address
204 Main St
Northport, NY 11768-1726
Phone
(631) 651-8141
NPI assigned
Dec 31, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Siobhan Costello
Title
Treasurer
Phone
(631) 651-8141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

204 Main St
Northport, NY 11768-1726

Mailing address

224 Main St
Northport, NY 11768-1726
Phone (631) 651-8141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260306002416 NY Part B Supplier - Ambulance Service Supplier 7012499189 Practice locations: Northport, NY

National Provider Directory

National Provider Directory

Locations

224 Main St
Northport, NY 11768

204 Main St
Northport, NY 11768
Phone (631) 651-8141

NPI Registry JSON

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

{
    "created_epoch": "1767139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1104782317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 MAIN ST",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681726",
            "telephone_number": "631-651-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MAIN ST",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681726",
            "telephone_number": "631-651-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF NORTHPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-31",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "SIOBHAN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "631-651-8141"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.