Active NPI
Golden Time Advanced Ambulance System Corp
- Land Ambulance
- Sabana Grande, PR
National Provider Identifier
1619751583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- GOLDEN TIME ADVANCED AMBULANCE SYSTEM CORP
- Practice address
- Reparto Sabana
Calle Puerto Rico G 14
Sabana Grande, PR 00637 - Phone
- (939) 344-3083
- NPI assigned
- Aug 22, 2023
- 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
- Nelson J Roman Mercado, E.M.T
- Title
- Ceo
- Phone
- (787) 383-6303
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | |||
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
Reparto Sabana
Calle Puerto Rico G 14
Sabana Grande, PR 00637
Mailing address
Reparto Sabana
Calle Puerto Rico G 14
Sabana Grande, PR 00637
Phone (939) 344-3083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240424002440 | PR | Part B Supplier - Ambulance Service Supplier | 6800236829 | Practice locations: Sabana Grande, PR |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692835200000",
"number": "1619751583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "REPARTO SABANA",
"address_2": "CALLE PUERTO RICO G 14",
"city": "SABANA GRANDE",
"state": "PR",
"postal_code": "00637",
"telephone_number": "939-344-3083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "REPARTO SABANA",
"address_2": "CALLE PUERTO RICO G 14",
"city": "SABANA GRANDE",
"state": "PR",
"postal_code": "00637",
"telephone_number": "939-344-3083"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN TIME ADVANCED AMBULANCE SYSTEM CORP",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-24",
"certification_date": "2023-08-22",
"status": "A",
"authorized_official_last_name": "ROMAN MERCADO",
"authorized_official_first_name": "NELSON",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "787-383-6303",
"authorized_official_credential": "E.M.T"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sabana Grande, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.