Organization Active NPI

Trinity Health of New England Emergency Medical Services, Inc.

  • Ambulance
  • Waterbury, CT
National Provider Identifier
1790335834
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
TRINITY HEALTH OF NEW ENGLAND EMERGENCY MEDICAL SERVICES, INC.
Practice address
15 W Dover St
Waterbury, CT 06706-1028
Phone
(203) 754-3355
NPI assigned
Sep 19, 2019
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
David Koscuk
Title
President
Phone
(203) 753-5055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU Primary

Addresses

Primary practice location

15 W Dover St
Waterbury, CT 06706-1028

Mailing address

15 W Dover St
Waterbury, CT 06706-1028
Phone (203) 753-5055

Other practice location 1

3 Country Club Rd
Cheshire, CT 06410-1631
Phone (203) 427-0652

Other practice location 2

201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005
Phone (203) 754-3179

Other practice location 3

67 Colt Ave
Torrington, CT 06790-6521
Phone (860) 489-7895

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200127001100 CT Part B Supplier - Ambulance Service Supplier 9537594262 Practice locations: Waterbury, CT; Torrington, CT; Stafford Springs, CT; Hartford, CT; Cheshire, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2123872Trinity Health of New England15 W Dover St, Waterbury, CT 06706Certificate of waiverJan 4, 2027

National Provider Directory

National Provider Directory

Locations

1795 Broad St
Hartford, CT 06114
Phone (203) 753-5055

67 Colt Ave
Torrington, CT 06790
Phone (860) 489-7895

1975 S Main St
Waterbury, CT 06706
Phone (203) 753-5055

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1790335834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W DOVER ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061028",
            "telephone_number": "203-753-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W DOVER ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061028",
            "telephone_number": "203-754-3355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Cheshire",
            "state": "CT",
            "postal_code": "064101631",
            "country_code": "US",
            "telephone_number": "203-427-0652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Chestnut Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Stafford Springs",
            "state": "CT",
            "postal_code": "060764005",
            "country_code": "US",
            "telephone_number": "203-754-3179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 Colt Ave",
            "address_purpose": "LOCATION",
            "city": "Torrington",
            "state": "CT",
            "postal_code": "067906521",
            "country_code": "US",
            "telephone_number": "860-489-7895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRINITY HEALTH OF NEW ENGLAND EMERGENCY MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "KOSCUK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-753-5055"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.

Verify at the official NPI Registry.