Active NPI
Holtsville Fire District
- Land Ambulance
- Holtsville, NY
National Provider Identifier
1235876046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220627001331 | NY | Part B Supplier - Ambulance Service Supplier | 3870972524 | Practice locations: Holtsville, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2292067 | Holtsville Fire District | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.