Individual provider Active NPI

Jason Walters, OWNER

  • Non-emergency Medical Transport (VAN)
  • Newburgh, NY
National Provider Identifier
1790426229
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
611417496 Issued in NY
Practice address
51 Leroy PL Apt 23
Newburgh, NY 12550-3627
Phone
(845) 375-5545
NPI assigned
Apr 6, 2022
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 611417496 NY Primary
Non-emergency Medical Transport (VAN) 343900000X 611471496 NY
Non-emergency Medical Transport (VAN) 343900000X NU

Addresses

Primary practice location

51 Leroy PL Apt 23
Newburgh, NY 12550-3627

Mailing address

51 Leroy PL Apt 23
Newburgh, NY 12550-3627
Phone (845) 375-5545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
611417496NYMDNon-emergency Medical Transport (VAN)
611471496NYMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
A 1 Medicaltransportation LLC Non-Emergency Medical Transport (Van) CurrentSince Aug 11, 2024 Accepting new patients
A & J Tri-State Transportation Inc Non-Emergency Medical Transport (Van) CurrentSince Apr 24, 2022 Accepting new patients
Starsnmars Non-Emergency Medical Transport (Van) CurrentSince Apr 10, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1790426229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 LEROY PL APT 23",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503627",
            "telephone_number": "845-375-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 LEROY PL APT 23",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503627",
            "telephone_number": "845-375-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JASON",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "611417496",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "611471496",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.