NPIMap

Organization Active NPI

Town of Kingston

  • Ambulance
  • Kingston, MA
National Provider Identifier
1356324289
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
3130 Issued in MA
Legal business name
TOWN OF KINGSTON
Doing business as
Kingston Fire Department
Practice address
105 Pembroke St
Kingston, MA 02364-1103
Phone
(781) 585-0531
NPI assigned
Nov 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Authorized official

Name
Mark Douglass
Title
Chief
Phone
(781) 585-0531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 3130 MA Primary

Addresses

Primary practice location

105 Pembroke St
Kingston, MA 02364-1103

Mailing address

PO Box 4110
Dept 5280
Woburn, MA 01888-4110
Phone (781) 585-0531

Other identifiers 6

IdentifierTypeStateIssuer
700623OtherHARVARD PILGRIM
1713868MedicaidMA
590006201OtherRR MEDICARE
801897OtherTUFTS HEALTH PLAN
000000026329OtherBMC HEALTHNET PLAN
0018977OtherNEIGHBORHOOD HEALTH

Other names 1

  • Kingston Fire Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120612000114 MA Part B Supplier - Ambulance Service Supplier 1355505959 Practice locations: Kingston, MA

National Provider Directory

National Provider Directory
Tax ID family
Kingston Fire Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

82 Smiths Ln
Kingston, MA 02364
Phone (781) 585-0531

105 Pembroke St
Kingston, MA 02364
Phone (781) 585-0531

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1356324289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4110",
            "address_2": "DEPT 5280",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018884110",
            "telephone_number": "781-585-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PEMBROKE ST",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023641103",
            "telephone_number": "781-585-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF KINGSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "781-585-0531"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MA",
            "license": "3130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "700623",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1713868",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590006201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "801897",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET PLAN",
            "identifier": "000000026329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0018977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingston Fire Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kingston Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.

Verify at the official NPI Registry.