Organization Active NPI

Town of Branford

  • Land Ambulance
  • Branford, CT
National Provider Identifier
1982604849
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
TOWN OF BRANFORD
Practice address
45 N Main St
Branford, CT 06405-3010
Phone
(203) 488-7266
Fax
(203) 315-3349
NPI assigned
Jul 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Thomas Mahoney
Title
Chief
Phone
(203) 488-7266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

45 N Main St
Branford, CT 06405-3010

Mailing address

45 N Main St
Branford, CT 06405-3010
Phone (203) 488-7266

Other identifiers 6

IdentifierTypeStateIssuer
004048021MedicaidCT
00404802100OtherBLUE CARE FAMILY
710C014A2CT01OtherCTBLUE CROSS/BLUE SHIELD
004048021OtherPREFERRED ONE
441590934OtherRAILROAD MEDICARE
OR0860OtherHEALTHNET

Other names 1

  • BRANFORD FIRE DEPARTMENT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091203000611 CT Part B Supplier - Ambulance Service Supplier 9234020165 Practice locations: Branford, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
07D2114495Branford Fire Department45 North Main St, Branford, CT 06405Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Town of Branford2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

45 N Main St
Branford, CT 06405
Phone (203) 488-7266

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1982604849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053010",
            "telephone_number": "203-488-7266",
            "fax_number": "203-315-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053010",
            "telephone_number": "203-488-7266",
            "fax_number": "203-315-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF BRANFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "203-488-7266"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004048021",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY",
            "identifier": "00404802100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "710C014A2CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "004048021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "441590934",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OR0860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRANFORD FIRE DEPARTMENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRANFORD FIRE DEPARTMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.