Organization Active NPI

Ellsworth Area Ambulance Service Inc

  • Land Ambulance
  • Ellsworth, WI
National Provider Identifier
1609827997
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
ELLSWORTH AREA AMBULANCE SERVICE INC
Practice address
151 S Plum St
Ellsworth, WI 54011-4137
Phone
(715) 273-4879
NPI assigned
May 12, 2006
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Dan Morth
Title
Director
Phone
(715) 273-4879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

151 S Plum St
Ellsworth, WI 54011-4137

Mailing address

PO Box 718
Ellsworth, WI 54011-0718

Other identifiers 7

IdentifierTypeStateIssuer
2525186-00MedicaidMN
41307200OtherWIHIRSP
8182337OtherMEDICA
000082275OtherADVOCARE MCHMO
396005590OtherTRICARE
7002089OtherPREFERRED ONE
41307200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041018000991 WI Part B Supplier - Ambulance Service Supplier 6709846397 Practice locations: Ellsworth, WI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1609827997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540110718",
            "fax_number": "336-510-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S PLUM ST",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540114137",
            "telephone_number": "715-273-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH AREA AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "MORTH",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-273-4879"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2525186-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "41307200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "8182337",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCARE MCHMO",
            "identifier": "000082275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "396005590",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "7002089",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41307200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.