NPIMap

Organization Active NPI

Lifepath Hospice, Inc.

  • Community Based Hospice Care Agency
  • Temple Terrace, FL
National Provider Identifier
1124171350
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
5018095 Issued in FL
Legal business name
LIFEPATH HOSPICE, INC.
Practice address
12470 Telecom Dr Ste 400
Temple Terrace, FL 33637-0904
Phone
(813) 877-2200
Fax
(813) 383-5041
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Crystal Bucciarelli
Title
VP, Legal Services
Phone
(813) 871-8075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 5018095 FL Primary

Addresses

Primary practice location

12470 Telecom Dr Ste 400
Temple Terrace, FL 33637-0904

Mailing address

12470 Telecom Dr Ste 300W
Attention: Compliance
Temple Terrace, FL 33637-0904
Phone (813) 871-8400

Other identifiers 1

IdentifierTypeStateIssuer
150022800MedicaidFL

Other names 1

  • LifePath Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090114000144 FL Part A Provider - Hospice 9335202589 Practice locations: Ruskin, FL; Temple Terrace, FL
O20131030000254 FL Part B Supplier - Clinic/Group Practice 9335202589 Receives reassigned benefits from 1 practitioner
Practice locations: Ruskin, FL; Tampa, FL; Temple Terrace, FL

Hospice certification: CCN 101507

Legal name
LIFEPATH HOSPICE, INC.
Doing business as
LIFEPATH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 4, 1984
Last certification
Sep 1, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 2006 in FL
Enrollment address
12470 Telecom Dr
Ste 400
Temple Terrace, FL 33637-0904

Care Compare: Hospice

Medicare Care Compare
Listed as
Lifepath HospiceCCN 101507
Ownership
For-Profit
Certified
Apr 4, 1984
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
10D1082889Lifepath Hospice, Inc12470 Telecom Dr - Ste 400, Temple Terrace, FL 33637Certificate of waiverApr 21, 2028

National Provider Directory

National Provider Directory

Locations

3725 Upper Creek Dr
Ruskin, FL 33573
Phone (813) 634-7621

4200 W Cypress St
Fl 6
Tampa, FL 33607

12470 Telecom Dr
Ste 400
Temple Terrace, FL 33637
Phone (813) 877-2200

11125 N 52nd St
Temple Terrace, FL 33617
Phone (813) 453-3881

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Robert M Walker Individual W-2 Managing EmployeeMD; May 17, 2024
Tara Friedman Individual Corporate OfficerChief Medical Officer Jan 1, 2024
Tracy Robert Individual Contracted Managing EmployeeVice President of Clinical Services May 17, 2024
Chapters Health System Inc Organization, Temple Terrace, FL Non-profit 5% Or Greater Direct Ownership Interest May 1, 2008 100%
Operational/Managerial Control May 1, 2008 100%
Andrew K Molosky Individual Contracted Managing EmployeeCeo Dec 15, 2017 100%
Corporate OfficerCeo Dec 15, 2017
Todd a Webb Individual Corporate OfficerCfo Apr 1, 2022
Rhonda G White Individual Corporate OfficerChief Operating Officer Apr 1, 2022
Valerie Zolman Individual Corporate OfficerChief Compliance Officer Apr 1, 2022
Paola Delp Individual Corporate OfficerChief Business Development Officer Jan 1, 2022
Kimberley Wolfe Individual W-2 Managing EmployeeExecutive Director May 17, 2024
Jerry Fogarty Individual Corporate DirectorDirector Oct 11, 2023
Jason M D'Auria Individual Contracted Managing EmployeeChief Operating Officer, Hospice May 17, 2024
Valerie H Goddard Individual Corporate DirectorSecretary May 20, 2014
Sheri Strobel Individual Corporate OfficerChief Information Officer Jan 1, 2022
Gayle Martin Individual Corporate DirectorDirector Oct 11, 2023
Edward Podgorski III Individual Corporate Director Oct 11, 2023
Adam Besnard Individual Corporate DirectorDirector Oct 11, 2023
Gayle Eaton Individual Corporate Director Dec 4, 2007
Mary Beth Reardon Individual Corporate DirectorVice Chair May 12, 2015
Latasha McFarlane Individual Corporate Director Oct 11, 2023
Nicole Romence Individual Corporate OfficerChief People Officer Jan 1, 2022
Crystal Bucciarelli Individual Contracted Managing EmployeeDirector of Legal Services Jan 1, 2019
Corporate DirectorDirector of Legal Services Jan 1, 2019

Owners & managing parties with NPI records 2

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1124171350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 300W",
            "address_2": "ATTENTION: COMPLIANCE",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8400",
            "fax_number": "813-871-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 400",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-877-2200",
            "fax_number": "813-383-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEPATH HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "BUCCIARELLI",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VP, LEGAL SERVICES",
        "authorized_official_telephone_number": "813-871-8075"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "5018095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150022800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifePath Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LifePath Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.