Port Chester-Rye-Rye Brook Emergency Medical Services Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

09930 Issued in NY

Legal business name

PORT CHESTER-RYE-RYE BROOK EMERGENCY MEDICAL SERVICES INC

Practice address

417 Ellendale Ave
Port Chester, NY 10573-3533

Phone

(914) 939-8112

Fax

(914) 939-1075

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Scott Moore, PARAMEDIC

Title

Administrator

Phone

(914) 939-8112

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Port Chester-Rye Volunteer Ambulance Corps Inc Former legal business name

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

Locations

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1497737381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 ELLENDALE AVE",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733533",
            "telephone_number": "914-939-8112",
            "fax_number": "914-939-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 ELLENDALE AVE",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733533",
            "telephone_number": "914-939-8112",
            "fax_number": "914-939-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CHESTER-RYE-RYE BROOK EMERGENCY MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "914-939-8112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "09930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01277756",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Chester-Rye Volunteer Ambulance Corps Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cynthia Poletsky, R.N.
• Angel Bautista Polimeni, MD
• Port Chester Carver Center Inc
• Port Chester Eyecare Inc
• Port Chester Operating LLC
• Paulette P Porteous-Cole, D.D.S.
• Loretta Lena Pouso, D.D.S.
• Kristen Helen Powers
• Destiny Precious Price
• Principle Homecare

• Ambulance in Port Chester, NY
• Providers in Port Chester, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.