Manorville Community Ambulance Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MANORVILLE COMMUNITY AMBULANCE INC

Practice address

184 South St
Manorville, NY 11949-3051

Phone

(631) 278-2140

NPI assigned

Oct 15, 2019

Organization subpart

No

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

Authorized official

Name

Nicholas Caporusso

Title

Assistant Chief

Phone

(631) 278-2140

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": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1568004208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 SOUH STREET",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "11949",
            "telephone_number": "631-278-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 SOUTH ST",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493051",
            "telephone_number": "631-278-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANORVILLE COMMUNITY AMBULANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "CAPORUSSO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "ASSISTANT CHIEF",
        "authorized_official_telephone_number": "631-278-2140"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis James Mackey
• Taylor Rae Madlinger, PA
• Jasmin Maghsoudlou, FNP
• Cristina Mancuso
• Tamiryn Mannix
• Carol Markland, LPN
• Donna Lynn Markovic, RN
• Marie Danie Marseille, LPN
• Samantha Ann Martino, LPN
• Maryhaven Center of Hope Inc.

• Land Ambulance in Manorville, NY
• Providers in Manorville, 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 Jul 28, 2022; 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.