Conneaut Lake Area Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CONNEAUT LAKE AREA AMBULANCE SERVICE

Practice address

290 S 4TH St Extension
Conneaut Lake, PA 16316

Phone

(814) 382-1133

Fax

(814) 382-9285

NPI assigned

Jan 26, 2006

Organization subpart

No

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

Authorized official

Name

Madeira T. Paraskos

Title

Ceo

Phone

(814) 382-1133

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1447220751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163160546",
            "telephone_number": "814-382-1133",
            "fax_number": "814-382-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S 4TH ST EXTENSION",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "16316",
            "telephone_number": "814-382-1133",
            "fax_number": "814-382-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEAUT LAKE AREA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "PARASKOS",
        "authorized_official_first_name": "MADEIRA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-382-1133"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "280240",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009844110002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devin Nicole Bielata, MA, NCC
• Chrissy M Bosley, LCSW QCSW
• Nour Majid Bussard, LPC
• Casey James Chapman, DC
• Kimberly Marie Conley, LCSW
• Conneaut Lake Chiropractic, PC
• Conneaut Valley Health Center Inc.
• Mindy Curtiss, CERT HEALTH COACH
• Ryan Scott Evans, D.O.
• Carrie Elizabeth Flemming

• Land Ambulance in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.