Elizabethtown-Lewis Emergency Squad

Primary specialty

AmbulanceTaxonomy code 341600000X

License

11409 Issued in NY

Legal business name

ELIZABETHTOWN-LEWIS EMERGENCY SQUAD

Practice address

8143 US RT 9
Lewis, NY 12950

Phone

(518) 873-2122

Fax

(518) 873-3784

NPI assigned

Feb 19, 2009

Organization subpart

No

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

Authorized official

Name

Patricia Bashaw

Title

President

Phone

(518) 873-2122

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420243200000",
    "number": "1285873976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122102269",
            "telephone_number": "888-603-2455",
            "fax_number": "888-603-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8143 US RT 9",
            "city": "LEWIS",
            "state": "NY",
            "postal_code": "12950",
            "telephone_number": "518-873-2122",
            "fax_number": "518-873-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETHTOWN-LEWIS EMERGENCY SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2015-01-03",
        "status": "A",
        "authorized_official_last_name": "BASHAW",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-873-2122"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "11409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03134232",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00772385",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Crumley
• Barbara Ann Denton, LCSW-R
• Essex County Treasurer
• Krystal Jaquish, M.A., SLP-CCC, TSLD

• All providers in Lewis, NY
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; 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.