Active NPI
Wantagh-Levittown Volunteer Ambulance Corps
- Land Ambulance
- Levittown, NY
National Provider Identifier
1609094887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 2933
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01981300 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100903000622 | NY | Part B Supplier - Ambulance Service Supplier | 3173647690 | Practice locations: Levittown, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2269477 | Wantagh-Levittown Volunteer Ambulance | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.