Active NPI
Village of New Berlin
- Land Ambulance
- New Berlin, NY
National Provider Identifier
1265604607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 6221
- Legal business name
- VILLAGE OF NEW BERLIN
- Practice address
- 13 South Main Street
New Berlin, NY 13411 - Phone
- (607) 847-6389
- Fax
- (607) 847-9865
- NPI assigned
- Mar 26, 2008
- Organization subpart
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080520000578 | NY | Part B Supplier - Ambulance Service Supplier | 1254400062 | Practice locations: New Berlin, NY |
National Provider Directory
National Provider DirectoryNPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Marie Anderson
- Title
- Clerk/Treasurer
- Phone
- (607) 847-6389
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 6221 | NY | Primary |
Addresses
Primary practice location
13 South Main Street
New Berlin, NY 13411
Mailing address
PO Box 535
Baldwinsville, NY 13027-0535
Phone (315) 635-1789
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03015230 | Medicaid | NY |
NPI Registry JSON
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1765756800000",
"number": "1265604607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 535",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130270535",
"telephone_number": "315-635-1789",
"fax_number": "315-635-3289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 SOUTH MAIN STREET",
"city": "NEW BERLIN",
"state": "NY",
"postal_code": "13411",
"telephone_number": "607-847-6389",
"fax_number": "607-847-9865"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE OF NEW BERLIN",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-26",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "CLERK/TREASURER",
"authorized_official_telephone_number": "607-847-6389"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NY",
"license": "6221",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03015230",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Berlin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.