Maricopa Ambulance, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MARICOPA AMBULANCE, LLC

Practice address

10234 N 19TH Ave
Phoenix, AZ 85021-1931

Phone

(480) 485-1800

NPI assigned

Jul 27, 2016

Last updated

Aug 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Jewell

Title

Chief Revenue Integration Officer

Phone

(844) 597-4911

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1932652815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660030",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660030",
            "telephone_number": "844-597-4911",
            "fax_number": "866-687-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10234 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850211931",
            "telephone_number": "480-485-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA AMBULANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF REVENUE INTEGRATION OFFICER",
        "authorized_official_telephone_number": "844-597-4911"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210198",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina M Marianetti, MSW, LCSW
• Rachel Angelica Mariani, MD
• Logan Mariano, DMD
• Mark Todd Marias, MD
• Zoran Maric, M.D.
• Maricopa County Adult Probation
• Maricopa County Attorney's Office Victim Compensation
• Maricopa County Correctional Health Services
• Maricopa County D.B.a. Maricopa County Depart
• Maricopa County D.B.a. Maricopa County Depart

• Land Ambulance in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Land Ambulance in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.

Verify at the official NPI Registry.