{"npi":"1396728622","type":"NPI-2","status":"active","name":{"display":"Stat Medical Transport LLC","other":[],"organization_name":"STAT MEDICAL TRANSPORT LLC","authorised_official":"Ron Berardocco"},"specialty":{"primary_taxonomy":"3416L0300X","primary_taxonomy_description":"Land Ambulance","slug":"land-ambulance","schema_org_specialty":null,"all":[{"code":"3416L0300X","description":"Land Ambulance","primary":false,"state":null,"license":null},{"code":"3416L0300X","description":"Land Ambulance","primary":true,"state":"PA","license":"05095"}]},"addresses":[{"purpose":"LOCATION","street_1":"740 BURMONT RD","city":"DREXEL HILL","state":"PA","postal_code":"190264349","country_code":"US","phone":"7175721321"},{"purpose":"MAILING","street_1":"PO BOX 337","city":"PILGRIM GARDENS","state":"PA","postal_code":"190260337","country_code":"US","phone":"7175721321"}],"license":{"state":"PA","number":"05095"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1013703770001","state":"PA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20050817000037","type_code":"12-59","type_desc":"PART B SUPPLIER - AMBULANCE SERVICE SUPPLIER","state":"PA","pac_id":"1850321183"}]},"enumeration_date":"2005-11-21","last_updated":"2024-09-06","_meta":{"source":"NPPES","snapshot_date":"2024-09-06","doc_url":"https://findmynpi.com/api"}}