Petersburgh Rescue Ambulance Squad Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

4129 Issued in NY

Legal business name

PETERSBURGH RESCUE AMBULANCE SQUAD INC

Practice address

2 Twin Hill Road
Petersburgh, NY 12138-0164

Phone

(518) 658-0113

NPI assigned

Oct 26, 2005

Last updated

Jan 22, 2024By 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

Lisa Adrion

Title

Treasurer

Phone

(518) 892-8005

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1992795462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130270535",
            "telephone_number": "800-927-5845",
            "fax_number": "315-635-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TWIN HILL ROAD",
            "city": "PETERSBURGH",
            "state": "NY",
            "postal_code": "121380164",
            "telephone_number": "518-658-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURGH RESCUE AMBULANCE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "ADRION",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "518-892-8005"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "4129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590015290",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01632053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Val Siobhan Fitzgerald-Matson
• Janet Haas, RN
• Sophia Artemis Lind, RD, LDN
• Cynthia G Mars, LPN

• Ambulance in Petersburgh, NY
• Providers in Petersburgh, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.