Organization Active NPI

Wantagh-Levittown Volunteer Ambulance Corps

  • Land Ambulance
  • Levittown, NY
National Provider Identifier
1609094887
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2933 Issued in NY
Legal business name
WANTAGH-LEVITTOWN VOLUNTEER AMBULANCE CORPS
Practice address
129 Balsam LN
Levittown, NY 11756-4901
Phone
(516) 731-1485
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Don Grimaldi
Title
Trustee
Phone
(516) 731-1485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 2933 NY Primary

Addresses

Primary practice location

129 Balsam LN
Levittown, NY 11756-4901

Mailing address

129 Balsam LN
Levittown, NY 11756-4901
Phone (516) 731-1485

Other identifiers 1

IdentifierTypeStateIssuer
01981300MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100903000622 NY Part B Supplier - Ambulance Service Supplier 3173647690 Practice locations: Levittown, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2269477Wantagh-Levittown Volunteer Ambulance129 Balsam Lane, Levittown, NY 11756Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

129 Balsam Ln
Levittown, NY 11756
Phone (516) 731-1485

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609094887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BALSAM LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117564901",
            "telephone_number": "516-731-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 BALSAM LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117564901",
            "telephone_number": "516-731-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANTAGH-LEVITTOWN VOLUNTEER AMBULANCE CORPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIMALDI",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "516-731-1485",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "2933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.