Organization Active NPI

Holtsville Fire District

  • Land Ambulance
  • Holtsville, NY
National Provider Identifier
1235876046
Registry record updated May 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
HOLTSVILLE FIRE DISTRICT
Practice address
1025 Waverly Ave
Holtsville, NY 11742-1101
Phone
(631) 484-2010
NPI assigned
May 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2022

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

Authorized official

Name
Justin Krause
Title
District Manager
Phone
(631) 484-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1025 Waverly Ave
Holtsville, NY 11742-1101

Mailing address

1025 Waverly Ave
Holtsville, NY 11742-1101
Phone (631) 484-2010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220627001331 NY Part B Supplier - Ambulance Service Supplier 3870972524 Practice locations: Holtsville, 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
33D2292067Holtsville Fire District1025 Waverly Ave, Holtsville, NY 11742Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

1025 Waverly Ave
Holtsville, NY 11742
Phone (631) 475-5238

NPI Registry JSON

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

{
    "created_epoch": "1652486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652486400000",
    "number": "1235876046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 WAVERLY AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421101",
            "telephone_number": "631-484-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 WAVERLY AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421101",
            "telephone_number": "631-484-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLTSVILLE FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-14",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DISTRICT MANAGER",
        "authorized_official_telephone_number": "631-484-2010"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holtsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; 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.