Organization Active NPI

Osprey Hospice LLC

  • Community Based Hospice Care Agency
  • East Brunswick, NJ
National Provider Identifier
1013527225
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
OSPREY HOSPICE LLC
Practice address
758 Route 18 Ste 103B
East Brunswick, NJ 08816-4936
Phone
(732) 955-6648
Fax
(732) 955-6673
NPI assigned
Aug 3, 2020
Last updated
Oct 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Olga M Maimon, MDNPI 1073598850
Title
Owner
Phone
(732) 768-6172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

758 Route 18 Ste 103B
East Brunswick, NJ 08816-4936

Mailing address

758 Route 18 Ste 103B
East Brunswick, NJ 08816-4936
Phone (732) 955-6648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210506002306 NJ Part A Provider - Hospice 3072922848 Practice locations: East Brunswick, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013527225. Details of each certification follow.

Hospice certification: CCN 311593

Legal name
OSPREY HOSPICE LLC
Doing business as
SPERO HOSPICE & PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 28, 2021
Last certification
Jun 28, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
May 15, 2020 in NJ
Enrollment address
758 Route 18 North
Suite 103B
East Brunswick, NJ 08816

Care Compare: Hospice

Medicare Care Compare
Listed as
Spero Hospice & Palliative CareCCN 311593 · All quality measures
Ownership
For-Profit
Certified
Jun 28, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

758 Route 18
Ste 103B
East Brunswick, NJ 08816
Phone (732) 955-6648

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Olga Maimon Individual 5% Or Greater Direct Ownership Interest Apr 17, 2023 100%
5% Or Greater Security Interest Apr 17, 2023 100%
Corporate OfficerCeo Apr 17, 2023 100%
W-2 Managing EmployeeCeo Apr 17, 2023 100%
Operational/Managerial ControlCeo Apr 17, 2023 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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 1

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": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1013527225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 ROUTE 18 STE 103B",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164936",
            "telephone_number": "732-955-6648",
            "fax_number": "732-955-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 ROUTE 18 STE 103B",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164936",
            "telephone_number": "732-955-6648",
            "fax_number": "732-955-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSPREY HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "MAIMON",
        "authorized_official_first_name": "OLGA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-768-6172",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.