CITY OF RANDOLPH — NPI 1528184249 (Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance in RANDOLPH, NE)

CMS-1500 Box 24J / 33a • NPI

1528184249

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3416L0300X (CMS 59)

Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance

Box 32 Service Location & ZIP+4

202 S MAIN ST, RANDOLPH, NE, 68771-0143

✓ 9-Digit EDI 837 ZIP+4 (68771-0143)

Practice Phone & Referral Fax

(402) 572-4019

Fax: (402) 991-0719

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1528184249 (CITY OF RANDOLPH) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1528184249)

Medicare Beneficiaries

Total Billed Services

860.8

Distinct CPT/HCPCS Codes

Medicare Allowed Total

$28,746.45

Actual Top Billed CPT / HCPCS Procedures (CMS Part B)

CPT / HCPCS	Clinical Procedure Description	Services
`A0425`	Ground mileage, per statute mile	823.8
`A0429`	Ambulance service, basic life support, emergency transport (bls-emergency)	37

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1528184249` (NPI-2 Organization / Facility)
Provider / Legal Name	CITY OF RANDOLPH
Plain-English Specialty	Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: `3416L0300X` (Ambulance, Land Transport)
Certifying / Licensing Body	State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Practice Location Address	202 S MAIN ST, RANDOLPH, NE, 68771-0143
Practice Telephone / Fax	Tel: (402) 572-4019 \| Fax: (402) 991-0719
Administrative Mailing Address	10802 FARNAM DR, OMAHA, NE, 68154-3237
Enumeration & Last Sync	Enumerated: 2007-03-22 \| CMS Record Updated: 2025-07-28
Authorized Official	ANTHONY BACKER (Captain)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

202 S MAIN ST, RANDOLPH, NE, 68771-0143

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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)

What Does Taxonomy Code 3416L0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 59 (Ambulance Service Provider)
Certifying / Accrediting Authority: State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Clinical Scope: Emergency 911 pre-hospital medical response or medically supervised inter-hospital critical care transport.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CITY OF RANDOLPH)

Typical CPT / Diagnostic Procedures:

Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
Pre-Hospital Trauma Immobilization, Airway Management & IV Access

Common Therapeutic Classes:

Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3416L0300X` — Ambulance, Land Transport Plain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance	State: NE \| License: `1247` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CITY OF RANDOLPH (NPI #1528184249)