Active NPI
Eden Hospice LLC
- Community Based Hospice Care Agency
- Warwick, RI
National Provider Identifier
1003683749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- EDEN HOSPICE LLC
- Practice address
- 4040 Post Rd
Warwick, RI 02886-9257 - Phone
- (401) 479-6800
- NPI assigned
- Dec 4, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eliyahu Rubin
- Title
- Ceo
- Phone
- (401) 479-6800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
4040 Post Rd
Warwick, RI 02886-9257
Mailing address
4040 Post Rd
Warwick, RI 02886-9257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231229000748 | RI | Part A Provider - Hospice | 3173973302 | Practice locations: Warwick, RI |
Hospice certification: CCN 411515
- Legal name
- EDEN HOSPICE LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 10, 2024
- Last certification
- May 2, 2024
- Organization structure
- LLC
- Enrollment address
- 4040 Post Rd
Warwick, RI 02886
Care Compare: Hospice
Medicare Care Compare- Listed as
- Eden Hospice LLC
- Certified
- May 10, 2024
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Aaron Y Rubin | 5% Or Greater Direct Ownership Interest | May 25, 2022 | 60% |
| Corporate Director | Nov 27, 2023 | 50% | |
| Louis Gellis | 5% Or Greater Direct Ownership Interest | May 25, 2022 | 40% |
| Crystal Ferreira | Operational/Managerial Control | May 25, 2022 | |
| Eliyahu Rubin | Corporate Officer | Nov 27, 2023 | |
| Corporate Director | Nov 27, 2023 | ||
| W-2 Managing Employee | Nov 27, 2023 | ||
| Faizul Suhail | Operational/Managerial Control | Feb 27, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Lincoln, RI
- NPI 1255694451
Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701648000000",
"number": "1003683749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 POST RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028869257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 POST RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028869257",
"telephone_number": "401-479-6800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDEN HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A",
"authorized_official_last_name": "RUBIN",
"authorized_official_first_name": "ELIYAHU",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "401-479-6800"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.