Organization Active NPI

Mile High Ambulance, LLC

  • Land Ambulance
  • Commerce City, CO
National Provider Identifier
1487928040
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
MILE HIGH AMBULANCE, LLC
Practice address
8451 Brighton Rd
Commerce City, CO 80022-5309
Phone
(303) 564-6636
NPI assigned
Feb 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Igor Balaban
Title
Authorized Signer
Phone
(303) 564-6636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

8451 Brighton Rd
Commerce City, CO 80022-5309

Mailing address

PO Box 22440
Denver, CO 80222-0440
Phone (303) 564-6636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120606000705 CO Part B Supplier - Ambulance Service Supplier 1951565746 Practice locations: Englewood, CO

National Provider Directory

National Provider Directory
Tax ID family
Mile High Ambulance LLC2 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

10686 E Bethany Dr
Aurora, CO 80014
Phone (303) 564-6636

8451 Brighton Rd
Commerce City, CO 80022
Phone (303) 564-6636

8200 E Pacific Pl
Ste 210
Denver, CO 80231
Phone (303) 564-6636

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1487928040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22440",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802220440",
            "telephone_number": "303-564-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 BRIGHTON RD",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800225309",
            "telephone_number": "303-564-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH AMBULANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "BALABAN",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "303-564-6636"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.