NPIMap

Organization Active NPI

Town of Stratford, Connecticut

  • Land Ambulance
  • Stratford, CT
National Provider Identifier
1508854928
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
C138P1 Issued in CT
Legal business name
TOWN OF STRATFORD, CONNECTICUT
Doing business as
Stratford Emergency Medical Service
Practice address
2712 Main St
Stratford, CT 06615-5816
Phone
(203) 385-4060
Fax
(203) 385-4156
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Jay Wahlberg
Title
Finance Director
Phone
(203) 385-4040

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X C138P1 CT
Land Ambulance 3416L0300X C138P1 CT Primary

Addresses

Primary practice location

2712 Main St
Stratford, CT 06615-5816

Mailing address

PO Box 417697
Boston, MA 02241-7697
Phone (203) 385-4060

Other identifiers 2

IdentifierTypeStateIssuer
P00078413OtherRAILROAD MEDICARE
004169480MedicaidCT

Other names 1

  • Stratford Emergency Medical Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000044 CT Part B Supplier - Ambulance Service Supplier 2062316318 Practice locations: Stratford, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Stratford Health Depart5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1508854928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417697",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417697",
            "telephone_number": "203-385-4060",
            "fax_number": "203-385-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155816",
            "telephone_number": "203-385-4060",
            "fax_number": "203-385-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF STRATFORD, CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "WAHLBERG",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "203-385-4040"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CT",
            "license": "C138P1",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CT",
            "license": "C138P1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00078413",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004169480",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stratford Emergency Medical Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stratford Emergency Medical Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.