Active NPI
Trinidad Ambulance District
- Land Ambulance
- Trinidad, CO
National Provider Identifier
1720202856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- TRINIDAD AMBULANCE DISTRICT
- Practice address
- 939 Robinson Ave
Trinidad, CO 81082-2832 - Phone
- (719) 846-6886
- Fax
- (719) 846-8431
- NPI assigned
- Apr 12, 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
- Gabriel Moreno, EMS CHIEF
- Title
- Executive Director
- Phone
- (719) 846-6886
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
939 Robinson Ave
Trinidad, CO 81082-2832
Mailing address
939 Robinson Ave
Trinidad, CO 81082-2832
Phone (719) 846-6886
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2205264 | Other | CO | AETNA |
| 06000327 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100210000252 | CO | Part B Supplier - Ambulance Service Supplier | 3476696626 |
1 other NPI on this enrollment Practice locations: Trinidad, CO |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Trinidad Ambulance District
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Trinidad, CO
- NPI 1649938093
Locations
939 Robinson Ave
Trinidad, CO 81082
Phone (719) 846-6886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1673913600000",
"number": "1720202856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "939 ROBINSON AVE",
"city": "TRINIDAD",
"state": "CO",
"postal_code": "810822832",
"telephone_number": "719-846-6886",
"fax_number": "719-846-8431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 ROBINSON AVE",
"city": "TRINIDAD",
"state": "CO",
"postal_code": "810822832",
"telephone_number": "719-846-6886",
"fax_number": "719-846-8431"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINIDAD AMBULANCE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-12",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A",
"authorized_official_last_name": "MORENO",
"authorized_official_first_name": "GABRIEL",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "719-846-6886",
"authorized_official_credential": "EMS CHIEF"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2205264",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06000327",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Trinidad, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.