NPIMap

Organization Active NPI

Badger Hospice, LLC

  • Community Based Hospice Care Agency
  • Brookfield, WI
National Provider Identifier
1013453505
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BADGER HOSPICE, LLC
Practice address
165 S Calhoun Rd
Brookfield, WI 53005-6302
Phone
(262) 777-0390
Fax
(262) 290-2824
NPI assigned
Jan 9, 2017
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Laura A Kukowski
Title
Ceo
Phone
(262) 777-0390

Specialties & licenses 1

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

Addresses

Primary practice location

165 S Calhoun Rd
Brookfield, WI 53005-6302

Mailing address

165 S Calhoun Rd
Brookfield, WI 53005-6302
Phone (262) 777-0390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170124000251 WI Part A Provider - Hospice 0840572020 Practice locations: Brookfield, WI; Burlington, WI
O20221107003243 WI Part B Supplier - Clinic/Group Practice 0840572020 Receives reassigned benefits from 3 practitioners
Practice locations: Brookfield, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013453505. Details of each certification follow.

Hospice certification: CCN 521600

Legal name
BADGER HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 26, 2017
Last certification
Jul 26, 2017
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Enrollment address
165 S Calhoun Rd
Brookfield, WI 53005-6302

Care Compare: Hospice

Medicare Care Compare
Listed as
Badger HospiceCCN 521600 · All quality measures
Ownership
For-Profit
Certified
Jul 26, 2017
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2124195Badger Hospice, LLC165 S Calhoun Road, Brookfield, WI 53005Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory

Locations

125 N Executive Dr
Ste 100
Brookfield, WI 53005
Phone (262) 222-1012

412 N Pine St
Burlington, WI 53105
Phone (262) 777-0390

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Glenn Toth Individual W-2 Managing EmployeeMD; Jan 1, 2021
Alok Goyal Individual Contracted Managing EmployeeMD; Jan 15, 2026
John Coury Individual 5% Or Greater Direct Ownership InterestOwner Aug 8, 2023 60%
Laura a Kukowski Individual 5% Or Greater Direct Ownership InterestCeo Aug 8, 2023 40%
Operational/Managerial ControlCeo/Admin Jun 1, 2018 100%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 12

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": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1013453505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S CALHOUN RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056302",
            "telephone_number": "262-777-0390",
            "fax_number": "262-290-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S CALHOUN RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056302",
            "telephone_number": "262-777-0390",
            "fax_number": "262-290-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BADGER HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "KUKOWSKI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-777-0390"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.