Active NPI
Medic Ambulance Service Inc
- Ambulance
- Vallejo, CA
National Provider Identifier
1871527887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- MEDIC AMBULANCE SERVICE INC
- Practice address
- 506 Couch St
Vallejo, CA 94590 - Phone
- (707) 644-1771
- Fax
- (707) 644-1784
- NPI assigned
- Jul 10, 2006
- Last updated
- Aug 21, 2019
- 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
- Mrs. Helen Frances Pierson
- Title
- Cfo
- Phone
- (916) 564-9040
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | CA | Primary |
Addresses
Primary practice location
506 Couch St
Vallejo, CA 94590
Mailing address
1001 Texas St Ste C
Fairfield, CA 94533-5723
Phone (916) 564-9040
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ81763Z | Medicaid | CA | |
| MTE00865F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120410000237 | CA | Part B Supplier - Ambulance Service Supplier | 1951348002 | Practice locations: Sacramento, CA; Vallejo, CA |
National Provider Directory
National Provider DirectoryLocations
1001 Texas St
Ste C
Fairfield, CA 94533
2349 Lexington St
Sacramento, CA 95815
Phone (916) 564-9040
506 Couch St
Vallejo, CA 94590
Phone (707) 644-1761
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Vallejo, CA
- NPI 1528561610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566345600000",
"number": "1871527887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 TEXAS ST STE C",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945335723",
"telephone_number": "916-564-9040",
"fax_number": "916-564-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 COUCH ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "94590",
"telephone_number": "707-644-1771",
"fax_number": "707-644-1784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDIC AMBULANCE SERVICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2019-08-21",
"status": "A",
"authorized_official_last_name": "PIERSON",
"authorized_official_first_name": "HELEN",
"authorized_official_middle_name": "FRANCES",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "916-564-9040",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ81763Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MTE00865F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.