Pine Island Volunteer Ambulance Corps, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

PINE ISLAND VOLUNTEER AMBULANCE CORPS, INC.

Doing business as

Pine Island Emergency Medical Services

Practice address

679 County Route 1
Pine Island, NY 10969-1718

Phone

(845) 258-4122

NPI assigned

Jan 25, 2023

Last updated

Jul 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Lee Pikul

Title

President

Phone

(845) 258-4122

Specialties & licenses 1

Addresses

Other names 1

• Pine Island Emergency Medical Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1235845124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "PINE ISLAND",
            "state": "NY",
            "postal_code": "109690264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 COUNTY ROUTE 1",
            "city": "PINE ISLAND",
            "state": "NY",
            "postal_code": "109691718",
            "telephone_number": "845-258-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE ISLAND VOLUNTEER AMBULANCE CORPS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "PIKUL",
        "authorized_official_first_name": "KELLY LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-258-4122"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Island Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Hoffmann
• Tara M Knubbert-Miller, MA/CCC-SLP
• Taneisha Audie-Ann Lauture
• Michelle Micheo, LPN
• Carissa Pacheco, LPN
• Brielle Rosario
• Aisling L Ryan, MSW
• Kendra Schust
• T.F. Herceg Inc. (SureHands Lift & Care Systems)

• Ambulance in Pine Island, NY
• Providers in Pine Island, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.