Organization Active NPI

Penfield Volunteer Emergency Ambulance Service Inc

  • Land Ambulance
  • Penfield, NY
National Provider Identifier
1306813118
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
33348 Issued in NY
Legal business name
PENFIELD VOLUNTEER EMERGENCY AMBULANCE SERVICE INC
Practice address
1585 Jackson Road
Penfield, NY 14526-0220
Phone
(585) 872-6060
Fax
(585) 872-2105
NPI assigned
Mar 1, 2006
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Mr. Richard Glynne Jones
Title
Treasurer
Phone
(585) 872-6060

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 2729 NY
Land Ambulance 3416L0300X 33348 NY Primary

Addresses

Primary practice location

1585 Jackson Road
Penfield, NY 14526-0220

Mailing address

8610 Main Street
Williamsville, NY 14221-7455
Phone (716) 204-3350

Other identifiers 1

IdentifierTypeStateIssuer
PENFIELDVOLOtherNYMONROE PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000654 NY Part B Supplier - Ambulance Service Supplier 3678466620 Practice locations: Penfield, 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
33D2184909The Penfield Volunteer Emergency Ambulance1585 Jackson Rd, Penfield, NY 14526Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1306813118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 MAIN STREET",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217455",
            "telephone_number": "716-204-3350",
            "fax_number": "716-247-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 JACKSON ROAD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145260220",
            "telephone_number": "585-872-6060",
            "fax_number": "585-872-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENFIELD VOLUNTEER EMERGENCY AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "GLYNNE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "585-872-6060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "2729",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "33348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONROE PLAN",
            "identifier": "PENFIELDVOL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.