Guardian Hospice MN LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

32588 Issued in MN

Legal business name

GUARDIAN HOSPICE MN LLC

Practice address

820 Lilac Dr N
Golden Valley, MN 55422-4700

Phone

(763) 205-3600

NPI assigned

Aug 11, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Eliyahu Jaffa

Title

President

Phone

(715) 800-0908

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Moments Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Hospice certification: CCN 241602

Legal name

GUARDIAN HOSPICE MN LLC

Doing business as

MOMENTS HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 20, 2017

Last certification

Nov 20, 2017

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Aug 10, 2016 in MN

Enrollment address

820 Lilac Dr N
Ste 210
Golden Valley, MN 55422-4754

Listed as

Moments HospiceCCN 241602

Ownership

For-Profit

Certified

Nov 20, 2017

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Mark D Stannard, MD

  • Family Medicine Physician
  • Hudson, WI
  • NPI 1700858933

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark D Stannard, MD

  • Family Medicine Physician
  • Hudson, WI
  • NPI 1700858933
  NPD (past)

Affiliated clinicians 15

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Loretta Omayemi Akpala, MD

  • General Practice Physician
  • Minneapolis, MN
  • NPI 1720721525

  Hospice

  Care Compare affiliation
• Mariam Anwar, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Coon Rapids, MN
  • NPI 1609044494

  Hospice

  Care Compare affiliation
• Richard Luboga Byakika, M.D.

  • Internal Medicine Physician
  • Maple Grove, MN
  • NPI 1407041445

  Hospice

  Care Compare affiliation
• Gehad Adel Elfarra, M.D

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1063649945

  Hospice

  Care Compare affiliation
• Jeffrey J Herickhoff, MD

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1245292424

  Hospice

  Care Compare affiliation
• Lawrence J Kerzner, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Minneapolis, MN
  • NPI 1134175698

  Hospice

  Care Compare affiliation
• Neha Sharma, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Eagan, MN
  • NPI 1871866095

  Hospice

  Care Compare affiliation
• Kurt Edward Walstrom, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1487853123

  Hospice

  Care Compare affiliation
• Thomas G Field, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Baldwin, WI
  • NPI 1336105840
  Care Compare affiliation
• Jendra Andrew Gosai, M.D.

  • Internal Medicine Physician
  • Menomonie, WI
  • NPI 1679861165

  Hospice

  Care Compare affiliation
• David Carl Hess, M.D.

  • Internal Medicine Physician
  • Hudson, WI
  • NPI 1871029116

  Hospice

  Care Compare affiliation
• Ryan McFarland, MD

  • Family Medicine Physician
  • Hudson, WI
  • NPI 1295183713

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1053865659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224700",
            "telephone_number": "763-205-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224700",
            "telephone_number": "763-205-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2631 Quentin Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554161958",
            "country_code": "US",
            "telephone_number": "612-655-4242 x54242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 E Walnut St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560011125",
            "country_code": "US",
            "telephone_number": "763-205-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GUARDIAN HOSPICE MN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "JAFFA",
        "authorized_official_first_name": "ELIYAHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-800-0908",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MN",
            "license": "32588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "32588",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moments Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda P Griffith, OTRL
• Nykole E. Grippe, PT
• Juli Ann Groath, D.P.T.
• Cayla Marie Groom, DPT
• Steven Jay Grosser, MD
• Cynthia Byron Guddal, LISW, CPRP
• Hina Guezmir, MD
• Guidepoint Services
• Gunther & Associates, P.a.
• Vandana Gupta, M.D.

• Community Based Hospice Care Agency in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.