Organization Active NPI

Seals Ambulance Service, Inc.

  • Land Ambulance
  • Indianapolis, IN
National Provider Identifier
1174528335
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0182 Issued in IN
Legal business name
SEALS AMBULANCE SERVICE, INC.
Practice address
2400 Roosevelt Ave
Indianapolis, IN 46218-4214
Phone
(844) 597-4911
Fax
(866) 687-2796
NPI assigned
Jun 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Robert A Jewell
Title
Chief Revenue Integration Officer
Phone
(844) 597-4911

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0182 IN Primary
Non-emergency Medical Transport (VAN) 343900000X 28771 IN

Addresses

Primary practice location

2400 Roosevelt Ave
Indianapolis, IN 46218-4214

Mailing address

PO Box 660884
Dallas, TX 75266-0884
Phone (844) 597-4911

Other identifiers 2

IdentifierTypeStateIssuer
000000182435OtherINBCBS-ANTHEM INSURANCE
200030170AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110610000030 IN Part B Supplier - Ambulance Service Supplier 9335326842 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

125 E 13th St
Anderson, IN 46016
Phone (317) 541-1200

2402 P St
Bedford, IN 47421
Phone (317) 541-1200

700 W Broadway St
Fortville, IN 46040
Phone (317) 541-1200

1134 Eastview Dr
Franklin, IN 46131
Phone (317) 541-1200

2400 Roosevelt Ave
Indianapolis, IN 46218
Phone (317) 541-1200

1718 Pleasant St
Noblesville, IN 46060
Phone (317) 541-1200

Practitioners & affiliated clinicians

Practitioners 6

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": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1174528335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660884",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660884",
            "telephone_number": "844-597-4911",
            "fax_number": "866-687-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROOSEVELT AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184214",
            "telephone_number": "844-597-4911",
            "fax_number": "866-687-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEALS AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF REVENUE INTEGRATION OFFICER",
        "authorized_official_telephone_number": "844-597-4911"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0182",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IN",
            "license": "28771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-ANTHEM INSURANCE",
            "identifier": "000000182435",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200030170A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.