NPIMap

Organization Active NPI

Foulkeways at Gwynedd

  • Community Based Hospice Care Agency
  • Gwynedd, PA
National Provider Identifier
1154600500
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
FOULKEWAYS AT GWYNEDD
Practice address
1120 Meetinghouse Rd
Gwynedd, PA 19436-1000
Phone
(215) 643-2200
Fax
(215) 591-2286
NPI assigned
Aug 16, 2011
Organization subpart
Yes
Parent organization
FOULKEWAYS AT GWYNEDDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Edna Marie Cristinzio
Title
Chief Financial Officer
Phone
(215) 283-7002

Specialties & licenses 1

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

Addresses

Primary practice location

1120 Meetinghouse Rd
Gwynedd, PA 19436-1000

Mailing address

1120 Meetinghouse Rd
Gwynedd, PA 19436-1000
Phone (215) 643-2200

Other identifiers 2

IdentifierTypeStateIssuer
5862OtherHIGHMARK BLUE SHIELD
002612OtherHIGHMARK MEDICARE SERVICE

Other names 1

  • Foulkeways Hospice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111014000339 PA Part A Provider - Hospice 4082600283 Practice locations: Gwynedd, PA

Hospice certification: CCN 391749

Legal name
FOULKEWAYS AT GWYNEDD
Doing business as
FOULKEWAYS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 28, 2012
Last certification
Feb 25, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Oct 24, 1973 in PA
Enrollment address
1120 Meetinghouse Rd
Gwynedd, PA 19436-1000

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Foulkeways HospiceCCN 391749
Ownership
Non-Profit
Certified
Jun 28, 2012
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Foulkeways at Gwynedd

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Kenneth Taylor Individual Corporate DirectorChair May 31, 2012
Foulkeways at Gwynedd Organization, Gwynedd, PA Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2011
Edna Cristinzio Individual W-2 Managing Employee Sep 1, 2011
Mary Knapp Individual W-2 Managing Employee Sep 1, 2011
Philip G Debaun Individual W-2 Managing EmployeeChief Executive Officer Jun 1, 2019

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1154600500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MEETINGHOUSE RD",
            "city": "GWYNEDD",
            "state": "PA",
            "postal_code": "194361000",
            "telephone_number": "215-643-2200",
            "fax_number": "215-591-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MEETINGHOUSE RD",
            "city": "GWYNEDD",
            "state": "PA",
            "postal_code": "194361000",
            "telephone_number": "215-643-2200",
            "fax_number": "215-591-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOULKEWAYS AT GWYNEDD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOULKEWAYS AT GWYNEDD",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "CRISTINZIO",
        "authorized_official_first_name": "EDNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "215-283-7002"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "5862",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK MEDICARE SERVICE",
            "identifier": "002612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foulkeways Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gwynedd, PA

Sources for this page

Verify at the official NPI Registry.