Mastic Volunteer Ambulance Company, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MASTIC VOLUNTEER AMBULANCE COMPANY, INC.

Practice address

1630 Montauk Hwy
Mastic, NY 11950-3010

Phone

(631) 281-4357

Fax

(631) 281-2422

NPI assigned

Oct 3, 2019

Last updated

Oct 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eugene Thomas Ommundsen

Title

Office Manager

Phone

(516) 523-5507

Specialties & licenses 1

Addresses

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": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1538700315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CENTRAL AVE.",
            "address_2": "SUITE 111",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105913301",
            "telephone_number": "914-366-4004",
            "fax_number": "914-366-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MONTAUK HWY",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119503010",
            "telephone_number": "631-281-4357",
            "fax_number": "631-281-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTIC VOLUNTEER AMBULANCE COMPANY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "OMMUNDSEN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-523-5507"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leyla Maltese, RN
• Jill Mandel
• Michelle Maria
• Kristina Marquette
• Catherine Martin, PTA
• Matt Family Residency
• Sarah Kate Mayott
• Octavia Denise McMillan-Mahabir, LPN
• Jason John Melia, LMHC
• Ashley Melillo

• Land Ambulance in Mastic, NY
• Providers in Mastic, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.