Organization Active NPI

Lake Ronkonkoma Fire District

  • Ambulance
  • Lake Ronkonkoma, NY
National Provider Identifier
1871373126
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
LAKE RONKONKOMA FIRE DISTRICT
Practice address
177 Portion Rd
Lake Ronkonkoma, NY 11779-2341
Phone
(860) 257-9201
NPI assigned
Oct 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Jennifer Dow
Title
Authorized Official
Phone
(860) 257-9201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

177 Portion Rd
Lake Ronkonkoma, NY 11779-2341

Mailing address

PO Box 290184
Wethersfield, CT 06129-0184
Phone (860) 257-9201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250131000331 NY Part B Supplier - Ambulance Service Supplier 4486183753 Practice locations: Ronkonkoma, NY

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
33D2289729Lake Ronkonkoma Fire District177 Portion Rd, Ronkonkoma, NY 11779Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

177 Portion Rd
Ronkonkoma, NY 11779
Phone (800) 336-6402

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1871373126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "860-257-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 PORTION RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792341",
            "telephone_number": "860-257-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE RONKONKOMA FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "DOW",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "860-257-9201"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.