Organization Active NPI

Middlesex Hospital

Doing business as Middlesex Hospital Homecare and Hospice

  • Community Based Hospice Care Agency
  • Middletown, CT
National Provider Identifier
1003873233
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MIDDLESEX HOSPITAL
Doing business as
Middlesex Hospital Homecare and Hospice
Practice address
117 Main Street Ext
Middletown, CT 06457-3849
Phone
(860) 358-5600
Fax
(860) 358-5723
NPI assigned
May 1, 2006
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDDLESEX HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Allison Dowe
Title
Director of Finance
Phone
(860) 358-5730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

117 Main Street Ext
Middletown, CT 06457-3849

Mailing address

770 Saybrook Rd
Middletown, CT 06457-4739
Phone (860) 358-5730

Other practice location 1

770 Saybrook Rd
Middletown, CT 06457-4739
Phone (860) 358-5730

Other names 1

  • Middlesex Hospital Homecare and Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160115001689 CT Part A Provider - Hospice 5092611731 Practice locations: Middletown, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003873233. Details of each certification follow.

Hospice certification: CCN 071522A

Legal name
MIDDLESEX HOSPITAL
Doing business as
MIDDLESEX HEALTH CARE AT HOME & HOSPICE PROGRAM
Organization structure
CorporationNon-profit
Incorporated
Jun 26, 1895 in CT
Enrollment address
117 Main Street Ext
Middletown, CT 06457-3849

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Office of Prof Services

Locations (25 of 43)

35 E Main St
Clinton, CT 06413
Phone (860) 669-8131

54 E Main St
Clinton, CT 06413

127 Norwich Ave
Colchester, CT 06415

100 Berlin Rd
Cromwell, CT 06416

5 Commerce Dr
Cromwell, CT 06416
Phone (860) 740-7432

60 Hicksville Rd
Cromwell, CT 06416
Phone (860) 635-4480

105 Main St
East Hampton, CT 06424
Phone (560) 358-5600

15 N Maple St
East Hampton, CT 06424

40 W High St
East Hampton, CT 06424
Phone (860) 267-8950

252 Westbrook Rd
Essex, CT 06426
Phone (860) 358-2700

95 Glastonbury Blvd
Glastonbury, CT 06033
Phone (860) 543-2233

439 Saybrook Rd
Higganum, CT 06441

451 Route 81
Killingworth, CT 06419

8 Hebron Rd
Marlborough, CT 06447
Phone (860) 295-5100

405 Main St
Middlefield, CT 06455

7 Lyman Rd
Middlefield, CT 06455

117 Main Street Ext
Middletown, CT 06457
Phone (860) 358-6000

134 Washington St
Middletown, CT 06457

155 Washington St
Middletown, CT 06457

2055 S Main St
Middletown, CT 06457

21 Pleasant St
Middletown, CT 06457
Phone (860) 344-8224

237 Main St
Middletown, CT 06457

393 Main St
Middletown, CT 06457

404 Main St
Middletown, CT 06457
Phone (860) 346-9204

421 Wadsworth St
Middletown, CT 06457
Phone (860) 347-9600

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vincent G Capece Individual Corporate OfficerPresident/Ceo Aug 1, 2012
Corporate DirectorBoard Member Aug 1, 2012
W-2 Managing EmployeePresident/Ceo Aug 1, 2012
Gary M Wallace Individual Corporate Director Feb 22, 2022
Christine H Repasy Individual Corporate Director Feb 22, 2022
Robert C Hinton Individual Corporate Director Feb 22, 2022
Mark D Lorenze Individual Corporate OfficerAsst Secretary Feb 22, 2022
Corporate Director Feb 22, 2022
Chandler J. Howard Individual Corporate OfficerVice Chair Feb 22, 2022
Corporate Director Feb 22, 2022
Mark S Bertolami Individual Corporate Director Feb 22, 2022
David C Benoit Individual Corporate Director Feb 22, 2022
Susan M Martin Individual Corporate OfficerVP/Cfo/Treasurer Aug 1, 2012
Corporate DirectorBoard Member Aug 1, 2012
W-2 Managing EmployeeVP/Cfo Aug 1, 2012
Jonathan D Levine Individual Corporate OfficerSecretary Feb 22, 2022
Corporate Director Feb 22, 2022
Bruce S. Macmillian Individual Corporate DirectorBoard Member Aug 1, 2012
Sabra R Purtill Individual Corporate Director Feb 22, 2022
John J Gauthier Individual Corporate Director Feb 22, 2022
Jean M. D'Aquila Individual Corporate Director Feb 22, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Middlesex Health Care at HomeMiddletown, CT, CCN 077086A Home health agency Operational/Managerial Control Feb 9, 1997

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 489

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 489

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1003873233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-358-5730",
            "fax_number": "860-358-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAIN STREET EXT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573849",
            "telephone_number": "860-358-5600",
            "fax_number": "860-358-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 Saybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064574739",
            "country_code": "US",
            "telephone_number": "860-358-5730",
            "fax_number": "860-358-5723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDDLESEX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLESEX HOSPITAL",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "DOWE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "860-358-5730"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesex Hospital Homecare and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.