Active NPI
Mercy Medical Transportation Inc
- Land Ambulance
- Mariposa, CA
National Provider Identifier
1457497026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- A195
- Legal business name
- MERCY MEDICAL TRANSPORTATION INC
- Practice address
- 5081 Hwy 140
Mariposa, CA 95338 - Phone
- (209) 966-2178
- Fax
- (209) 966-4901
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Richard Fred Roesch I, CEO
- Title
- President
- Phone
- (209) 966-5762
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | A195 | CA | Primary |
Addresses
Primary practice location
5081 Hwy 140
Mariposa, CA 95338
Mailing address
PO Box 5004
Mariposa, CA 95338-5004
Phone (209) 966-5762
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MTE00742F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040429000632 | CA | Part B Supplier - Ambulance Service Supplier | 9335136480 |
1 other NPI on this enrollment Practice locations: Mariposa, CA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Westmed SCC
- Land Ambulance
- Sunnyvale, CA
- NPI 1184779225
O20040429000632
National Provider Directory
National Provider Directory- Tax ID family
- Mercy Medical Transport
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Valley Center, CA
- NPI 1164517520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209427200000",
"number": "1457497026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5004",
"city": "MARIPOSA",
"state": "CA",
"postal_code": "953385004",
"telephone_number": "209-966-5762",
"fax_number": "209-966-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5081 HWY 140",
"city": "MARIPOSA",
"state": "CA",
"postal_code": "95338",
"telephone_number": "209-966-2178",
"fax_number": "209-966-4901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCY MEDICAL TRANSPORTATION INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-30",
"last_updated": "2008-04-29",
"status": "A",
"authorized_official_last_name": "ROESCH",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "FRED",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "209-966-5762",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "I",
"authorized_official_credential": "CEO"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "CA",
"license": "A195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MTE00742F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mariposa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.