Kenmare Ambulance Service
Organization Active NPI Land Ambulance · Kenmare, ND
NPI 1497962393 · NPPES record last updated Jul 20, 2026
Key facts
- NPI
- 1497962393
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 061 (ND)
- Legal business name
- KENMARE AMBULANCE SERVICE
- Practice address
- 310 N Central Ave
Kenmare, ND 58746 - Phone
- (701) 509-6285
- NPI assigned
- May 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Sara Staskywicz
- Title
- Secretary Treasurer
- Phone
- (701) 385-4488
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100814000265 | ND | Part B Supplier - Ambulance Service Supplier | 9234263187 | Practice locations: Kenmare, ND |
National Provider Directory
Locations
310 N Central Ave
Kenmare, ND 58746
Phone (701) 385-4231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 061 | ND | Yes |
Addresses
Primary practice location
310 N Central Ave
Kenmare, ND 58746
Mailing address
PO Box 817
Kenmare, ND 58746-0817
Phone (701) 509-6285
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53937 | Medicaid | ND | |
| 590002528 | Other | ND | RAILROAD MEDICARE |
| 7205 | Other | ND | BLUD CROSS BLUE SHIELD |
Other names
- KENMARE AMBULANCE SERVICE
Other providers in Kenmare, ND
- Compass Health Inc
- Eric M Ganes
- Tesha Gustafson
- Kevin John Holmgren
- Sabrina Kay Jones
- Kenmare Dental Clinic
- Kenmare Drug
- Kenmare Lakeview LLC
- Kenmare Wheels & Meals, Inc.
- Olubukola O Oni
All providers in Kenmare, ND · Land Ambulance in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.