PROFESSIONAL MEDICAL TRANSPORT, INC
NPI 1720196843
Ambulance - Land Transport in Mesa, AZ
- Organization
- Ambulance
- Land Transport
- CLIA Number: 03D2149632
- CLIA Cert. Type: Ambulance
- CLIA Exp. Date: 06-06-2028
About PROFESSIONAL MEDICAL TRANSPORT, INC
This page provides the complete NPI Profile along with additional information for Professional Medical Transport, Inc, a provider established in Mesa, Arizona operating as a Ambulance, focusing in land transport . The healthcare provider is registered in the NPI registry with number 1720196843 assigned on August 2006. The practitioner's primary taxonomy code is 3416L0300X with license number CON # 71 (AZ). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Timothy Joseph Dorn (Chief Administrative Officer)
- NPI
- 1720196843 Verify this NPI
- Provider Name
- PROFESSIONAL MEDICAL TRANSPORT, INC
- Entity Type
- Organization
- Location Address
- 617 W MAIN ST MESA, AZ 85201
- Location Phone
- (480) 446-2513
- Mailing Address
- PO BOX 847102 DALLAS, TX 75284
- Mailing Phone
- (800) 913-9106
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-28-2006
- Last Update Date
- 09-16-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ambulance Land Transport
- Taxonomy Code
- 3416L0300X
- Type
- Transportation Services
- License No.
- CON # 71
- License State
- AZ
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 341600000X | Transportation Services | Ambulance |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200780 | MEDICAID (05) | AZ |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D2149632
- Facility Type
- Ambulance
- Certificate Effective Date
- June 07, 2026
- Certificate Expiration Date
- June 06, 2028
- Laboratory Director
- GLENN KASPRZYK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Professional Medical Transport, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PROFESSIONAL MEDICAL TRANSPORT, INC
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720196843, enumerated as an "organization" on August 28, 2006.
The provider is located at 617 W MAIN ST MESA, AZ 85201 and the phone number is (480) 446-2513.
Ambulance with taxonomy code 3416L0300X and a focus in Land Transport.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
