Active NPI
Nassau Ambulance
- Ambulance
- Nassau, NY
National Provider Identifier
1700066479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 10786
- Legal business name
- NASSAU AMBULANCE
- Practice address
- 498 McClellan Dr
Nassau, NY 12123-3930 - Phone
- (888) 603-2455
- Fax
- (518) 391-2601
- NPI assigned
- Nov 9, 2007
- Last updated
- Feb 2, 2021
- 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. Robert W Valenty
- Title
- Board Member
- Phone
- (888) 603-2455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 10786 | NY | Primary |
Addresses
Primary practice location
498 McClellan Dr
Nassau, NY 12123-3930
Mailing address
PO Box 787
Latham, NY 12110-0787
Phone (888) 603-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02966003 | 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 |
|---|---|---|---|---|
| O20080104000544 | NY | Part B Supplier - Ambulance Service Supplier | 6608956545 | Practice locations: Nassau, 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 |
|---|---|---|---|
| 33D2009752 | Nassau Ambulance Inc | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194566400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612224000000",
"number": "1700066479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 787",
"city": "LATHAM",
"state": "NY",
"postal_code": "121100787",
"telephone_number": "888-603-2455",
"fax_number": "518-391-2601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 MCCLELLAN DR",
"city": "NASSAU",
"state": "NY",
"postal_code": "121233930",
"telephone_number": "888-603-2455",
"fax_number": "518-391-2601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NASSAU AMBULANCE",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-09",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A",
"authorized_official_last_name": "VALENTY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "BOARD MEMBER",
"authorized_official_telephone_number": "888-603-2455",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "NY",
"license": "10786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02966003",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nassau, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.