NPIMap

Organization Active NPI

Community Hospital of Anaconda

Doing business as Anaconda Pintler Hospice

  • Community Based Hospice Care Agency
  • Anaconda, MT
National Provider Identifier
1023066453
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
10062 Issued in MT
Legal business name
COMMUNITY HOSPITAL OF ANACONDA
Doing business as
Anaconda Pintler Hospice
Practice address
305 W Pennsylvania St
Anaconda, MT 59711-1900
Phone
(406) 563-8667
Fax
(406) 563-8665
NPI assigned
May 5, 2006
Last updated
Nov 19, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL OF ANACONDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Authorized official

Name
Susan M Kaasch
Title
Department Director
Phone
(406) 563-8667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 10062 MT Primary

Addresses

Primary practice location

305 W Pennsylvania St
Anaconda, MT 59711-1900

Mailing address

305 W Pennsylvania St
Anaconda, MT 59711-1900
Phone (406) 563-8667

Other identifiers 1

IdentifierTypeStateIssuer
00750087MedicaidMT

Other names 1

  • Anaconda Pintler Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030507000031 MT Part A Provider - Hospice 8123938974 Practice locations: Anaconda, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023066453. Details of each certification follow.

Hospice certification: CCN 271506

Legal name
COMMUNITY HOSPITAL OF ANACONDA
Doing business as
PINTLER HOME OPTIONS - ANACONDA PINTLER HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 20, 1991
Last certification
Jul 21, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 1969 in MT
Enrollment address
118 E 7TH St
Ste 1a
Anaconda, MT 59711-2953

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Anaconda Pintler HospiceCCN 271506 · All quality measures
Ownership
Non-Profit
Certified
Mar 20, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Comm Hosp Anaconda18 organizations share this tax ID, including this one
Part of
Comm Hosp Anaconda

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Tricia H Wagner Individual W-2 Managing EmployeeDirector Rev Int Feb 1, 2018
Audrey J Aspholm Individual Corporate Director Jan 1, 2018
Freddy J Bartoletti Individual Corporate Director Sep 1, 2016
Lee Ann Bartoletti Individual Corporate DirectorBoard Member Jan 1, 2005
Christine M Connors Individual Corporate Director Jan 1, 2018
Kristy R McKay Individual Corporate Director Jan 1, 2018
Stephanie J Denham Individual Corporate OfficerCfo Jan 1, 2023
Kira Ann Conn Individual Corporate Director Jan 1, 2023
Stan L Blaz Individual Corporate DirectorBoard Member Sep 1, 1999
Margaret I Hickey Boynton Individual Corporate OfficerCeo Mar 1, 2005
Community Hospital of Anaconda Organization, Anaconda, MT Non-profit Other Mar 13, 1969 100%
Jamie L Johnson Individual Corporate Officer Dec 1, 2005

Owners & managing parties with NPI records 6

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
Community Nursing Home of AnacondaAnaconda, MT, CCN 275065 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 1969
Jan 1, 1969

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

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1023066453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W PENNSYLVANIA ST",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111900",
            "telephone_number": "406-563-8667",
            "fax_number": "406-563-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W PENNSYLVANIA ST",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111900",
            "telephone_number": "406-563-8667",
            "fax_number": "406-563-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL OF ANACONDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL OF ANACONDA",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "KAASCH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DEPARTMENT DIRECTOR",
        "authorized_official_telephone_number": "406-563-8667"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MT",
            "license": "10062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00750087",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaconda Pintler Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaconda, MT

Sources for this page

Verify at the official NPI Registry.