SOUTH LAKE COUNTY FIRE PROTECTION DISTRICT
NPI 1265432801
Ambulance - Land Transport in Middletown, CA

Q: What is South Lake County Fire Protection District's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Active since July 26, 2005

21095 HIGHWAY 175, MIDDLETOWN, CA 95461(707) 987-3089 Get Directions Write a Review

NPPES record last updated: December 17, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2019, Nov 13, 2019 (2 updates tracked since 2019).

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About South Lake County Fire Protection District NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH LAKE COUNTY FIRE PROTECTION DISTRICT (NPI 1265432801) is a healthcare organization registered as a land transport in Middletown, California and active in the NPI registry since July 2005. The organization lists Greg Bertelli, Fire Chief, as its authorized official.

NPPES Registry Identity

NPI1265432801

Entity TypeOrganization

Primary Taxonomy3416L0300X

Legal Business NameSOUTH LAKE COUNTY FIRE PROTECTION DISTRICT

Location Address21095 HIGHWAY 175Middletown, CA 95461-9527

Mailing AddressPo Box 269110Sacramento, CA 95826-9110

Phone(707) 987-3089

Organization SubpartNo

Authorized OfficialGreg BertelliFire Chief · (707) 279-2125

Enumeration DateJuly 26, 2005

Last NPPES UpdateDecember 17, 20192 updates tracked since enumeration

✔ NPI 1265432801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services

Taxonomy Code3416L0300X

21095 HIGHWAY 175, Middletown, CA 95461

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Other Identifiers 2

Other590004954Rrb

MedicaidZZZ83591ZCA

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

South Lake County Fire Protection District is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20120314000240Non-DME Part B · Ambulance Service SupplierDue dateJanuary 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425

Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.

3,375 services199 patients

Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427

Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.

196 services162 patients

Ambulance service, basic life support, emergency transport (bls-emergency) A0429

Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.

58 services53 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Lake County Fire Protection District's NPI number?

The NPI number for South Lake County Fire Protection District is 1265432801. It was assigned to this organization in the NPPES registry on July 26, 2005.

Where is South Lake County Fire Protection District located?

South Lake County Fire Protection District is located at 21095 Highway 175, Middletown, CA 95461. The listed phone number is (707) 987-3089.

What is South Lake County Fire Protection District's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Is South Lake County Fire Protection District enrolled in Medicare?

Yes. South Lake County Fire Protection District is registered in the Medicare PECOS enrollment system.

When is South Lake County Fire Protection District's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Ambulance Service Supplier) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for South Lake County Fire Protection District was last updated on December 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.