Individual provider Active NPI

Rodolfo Pancubila

  • Non-emergency Medical Transport (VAN)
  • Crown Point, IN
National Provider Identifier
1881103752
Registry record updated Sep 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
1225 Creekside Dr
Crown Point, IN 46307-8215
Phone
(219) 669-0591
NPI assigned
Sep 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X IN Primary

Addresses

Primary practice location

1225 Creekside Dr
Crown Point, IN 46307-8215

Mailing address

PO Box 849
Crown Point, IN 46308-0849

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

NPI Registry JSON

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

{
    "created_epoch": "1506124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506124800000",
    "number": "1881103752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463080849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CREEKSIDE DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078215",
            "telephone_number": "219-669-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCUBILA",
        "first_name": "RODOLFO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-23",
        "last_updated": "2017-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2017; 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.