Organization Active NPI

Westbrook Ambulance Association, Inc

  • Land Ambulance
  • Westbrook, CT
National Provider Identifier
1386731271
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
E4515 Issued in CT
Legal business name
WESTBROOK AMBULANCE ASSOCIATION, INC
Practice address
1316 Boston Post Rd
Westbrook, CT 06498-1972
Phone
(860) 663-3634
Fax
(860) 663-3795
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandra Castlevetro
Title
Billing Manager
Phone
(860) 663-3634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X E4515 CT Primary

Addresses

Primary practice location

1316 Boston Post Rd
Westbrook, CT 06498-1972

Mailing address

PO Box 682
Westbrook, CT 06498-0682
Phone (860) 663-3634

Other identifiers 2

IdentifierTypeStateIssuer
732661OtherCTCONNECTICARE
CT7461OtherCTHEALTHNET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120128000000 CT Part B Supplier - Ambulance Service Supplier 3173780491 Practice locations: Westbrook, CT

National Provider Directory

National Provider Directory

Locations

1316 Boston Post Rd
Westbrook, CT 06498
Phone (860) 399-7000

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386731271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 682",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064980682",
            "telephone_number": "860-663-3634",
            "fax_number": "860-663-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 BOSTON POST RD",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064981972",
            "telephone_number": "860-663-3634",
            "fax_number": "860-663-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTBROOK AMBULANCE ASSOCIATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTLEVETRO",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "860-663-3634"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CT",
            "license": "E4515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "732661",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CT7461",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.