Prospect Volunteer Ambulance, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3226 Issued in NY

Legal business name

PROSPECT VOLUNTEER AMBULANCE, INC.

Doing business as

STaR Volunteer Ambulance

Practice address

915 Trenton Falls St.
Prospect, NY 13435

Phone

(585) 768-2192

NPI assigned

Feb 28, 2006

Last updated

Oct 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Shorey

Title

Director

Phone

(315) 831-1010

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• STaR Volunteer Ambulance Doing business as

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

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1447226378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409",
            "city": "REMSEN",
            "state": "NY",
            "postal_code": "134380409",
            "telephone_number": "315-831-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 TRENTON FALLS ST.",
            "city": "PROSPECT",
            "state": "NY",
            "postal_code": "13435",
            "telephone_number": "585-768-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT VOLUNTEER AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "SHOREY",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-831-1010"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "3226",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01767197",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STaR Volunteer Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Lyn Maciol

• Land Ambulance in Prospect, NY
• Providers in Prospect, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.