NPIMap

Organization Active NPI

Hospice of the Sacred Heart

  • Community Based Hospice Care Agency
  • Moosic, PA
National Provider Identifier
1063498541
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
16561601 Issued in PA
Legal business name
HOSPICE OF THE SACRED HEART
Practice address
30 Ed Preate Dr Ste 108
Moosic, PA 18507-1755
Phone
(570) 706-2400
Fax
(570) 970-9717
NPI assigned
Dec 16, 2005
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Ms. Diane Baldi, RN,CHPN
Title
Executive Director
Phone
(570) 706-2400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 16561601 PA Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

30 Ed Preate Dr Ste 108
Moosic, PA 18507-1755

Mailing address

30 Ed Preate Dr Ste 108
Moosic, PA 18507-1755
Phone (570) 706-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000030 PA Part A Provider - Hospice 4284529009 Practice locations: Moosic, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063498541. Details of each certification follow.

Hospice certification: CCN 391656

Legal name
HOSPICE OF THE SACRED HEART
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 26, 2004
Last certification
Jan 13, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Aug 18, 2003 in PA
Enrollment address
30 Ed Preate Dr
Ste 108
Moosic, PA 18507-1755

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of the Sacred HeartCCN 391656 · All quality measures
Ownership
Non-Profit
Certified
May 26, 2004
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
39D1025482Hospice of the Sacred Heart30 Ed Preate Dr Suite 108, Moosic, PA 18507Certificate of waiverMay 9, 2028

National Provider Directory

National Provider Directory

Locations

30 Ed Preate Dr
Moosic, PA 18507

30 Ed Preate Dr
Ste 108
Moosic, PA 18507
Phone (570) 706-2400

53 Glenmaura National Blvd
Ste 120
Moosic, PA 18507

53 Glenmaura National Blvd
Scranton, PA 18507
Phone (570) 496-5101

130 Wilkes Barre Township Blvd
Wilkes Barre, PA 18702
Phone (570) 706-2400

600 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 706-2400

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Dominick L Denaples Individual Corporate DirectorBoard Member Apr 26, 2005
Diane M Baldi Individual Corporate OfficerCeo Mar 10, 2004
W-2 Managing EmployeeAd;Ceo Aug 18, 2003
Frank a Bucci Individual Corporate OfficerPresident, Board of Directors Mar 10, 2004
Corporate DirectorBoard Member Mar 10, 2004
John Anecki Individual Corporate OfficerVice President/Secretary, Board Mar 10, 2004
Corporate DirectorBoard Member Mar 10, 2004
Robert Tambur Individual Corporate DirectorBoard Member Mar 3, 2004
Sam Lesante Individual Corporate DirectorBoard Member Mar 10, 2004
Linda Weiland Individual W-2 Managing EmployeeCoo Sep 18, 2012
Bryan E Boyle Individual Corporate OfficerTreasurer, Board of Directors Jun 17, 2008
Corporate DirectorBoard Member Jun 17, 2008
William Reber Individual Corporate DirectorBoard Member Mar 10, 2004

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

Affiliated clinicians 55

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

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1063498541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ED PREATE DR STE 108",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071755",
            "telephone_number": "570-706-2400",
            "fax_number": "570-970-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ED PREATE DR STE 108",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071755",
            "telephone_number": "570-706-2400",
            "fax_number": "570-970-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF THE SACRED HEART",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "BALDI",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-706-2400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN,CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PA",
            "license": "16561601",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moosic, PA

Sources for this page

Verify at the official NPI Registry.