Active NPI
Town of Andover
- Land Ambulance
- Andover, MA
National Provider Identifier
1619979796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 3056
- Legal business name
- TOWN OF ANDOVER
- Practice address
- 32 North Main Street
Andover, MA 01810-3513 - Phone
- (978) 475-1281
- Fax
- (978) 475-6654
- NPI assigned
- Aug 10, 2005
- 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
- Michael Brendan Mansfield
- Title
- Fire Chief
- Phone
- (978) 475-1281
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 3056 | MA | Primary |
Addresses
Primary practice location
32 North Main Street
Andover, MA 01810-3513
Mailing address
19 Norfolk Avenue
South Easton, MA 02375-1911
Phone (508) 297-2068
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700871 | Medicaid | MA | |
| 000000028099 | Other | MA | BMC HEALTHNET PLAN |
| 016059 | Other | MA | MASS MEDEX |
| 103474100 | Other | MA | DEPARTMENT OF LABOR |
| 0008794 | Other | MA | NEIGHBORHOOD HEALTH |
| 10694 | Other | MA | FALLON |
| 016059 | Other | MA | BC/BS |
| 590011162 | Other | MA | RR MEDICARE |
| 700591 | Other | MA | HARVARD PILGRIM |
| 801595 | Other | MA | TUFTS |
| 155028XX | Other | NY | PREFERRED CARE NY |
Other names 1
- Andover Fire Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090212000087 | MA | Part B Supplier - Ambulance Service Supplier | 3072678747 | Practice locations: Andover, MA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Andover Health Department
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- State or Local Public Health Clinic/Center
- Andover, MA
- NPI 1609913706
-
- Local Education Agency (LEA)
- Andover, MA
- NPI 1669506515
Locations
32 N Main St
Andover, MA 01810
Phone (978) 475-1281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352937600000",
"number": "1619979796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 NORFOLK AVENUE",
"city": "SOUTH EASTON",
"state": "MA",
"postal_code": "023751911",
"telephone_number": "508-297-2068",
"fax_number": "508-297-2699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 NORTH MAIN STREET",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018103513",
"telephone_number": "978-475-1281",
"fax_number": "978-475-6654"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOWN OF ANDOVER",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-10",
"last_updated": "2012-11-15",
"status": "A",
"authorized_official_last_name": "MANSFIELD",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "BRENDAN",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "978-475-1281"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "MA",
"license": "3056",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700871",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTHNET PLAN",
"identifier": "000000028099",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS MEDEX",
"identifier": "016059",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR",
"identifier": "103474100",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0008794",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "10694",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "016059",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "590011162",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "700591",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "801595",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE NY",
"identifier": "155028XX",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Andover Fire Department",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.