NPIMap

Organization Active NPI

Hopedale Medical Foundation

Doing business as Hopedale Medical Complex

  • Critical Access Hospital
  • Hopedale, IL
National Provider Identifier
1174569438
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
1706400 Issued in IL
Legal business name
HOPEDALE MEDICAL FOUNDATION
Doing business as
Hopedale Medical Complex
Practice address
107 Tremont
Hopedale, IL 61747-0267
Phone
(309) 449-3321
Fax
(309) 449-5441
NPI assigned
Jun 22, 2006
Last updated
Feb 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

Name
Dr. Alfred Nello Rossi, M.D.
Title
Ceo
Phone
(309) 449-4338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 1706400 IL Primary

Addresses

Primary practice location

107 Tremont
Hopedale, IL 61747-0267

Mailing address

PO Box 267
Hopedale, IL 61747-0267
Phone (309) 449-3321

Other names 1

  • Hopedale Medical Complex Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000295 IL Part A Provider - Critical Access Hospital 1153363577 Receives reassigned benefits from 13 practitioners
Practice locations: Hopedale, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174569438. Details of each certification follow.

Hospital certification: CCN 141330

Legal name
HOPEDALE MEDICAL FOUNDATION
Doing business as
HOPEDALE MEDICAL COMPLEX
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2003
Last certification
Feb 21, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Jun 7, 1961 in IL
Enrollment address
107 Tremont St
Hopedale, IL 61747-7525

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Hopedale HospitalCCN 141330 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

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
Emily Whitson Individual Contracted Managing Employee Jan 1, 2020
Corporate OfficerCoo Jan 1, 2020
Corporate Director Jan 1, 2020
W-2 Managing Employee Jan 1, 2020
Operational/Managerial Control Jan 1, 2020
Donald G Oswald Individual Corporate Officer Jan 20, 2011
Joan Harrison Individual Corporate OfficerBoard Member Jan 1, 2023
Christopher Campbell Individual Corporate OfficerBoard Member Jun 1, 1992
Thomas C Hieser Individual Corporate OfficerBoard Member Jun 30, 1995
Nicholas Brandl Rossi Individual Corporate Officer Jan 1, 2023
Matthew Rossi Individual Corporate Officer Jun 1, 1992
Alfred N Rossi Individual Corporate Officer Jan 28, 2001
Roland E Rich Individual Corporate Officer May 30, 1997

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

Affiliated clinicians 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1174569438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "617470267",
            "telephone_number": "309-449-3321",
            "fax_number": "309-449-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 TREMONT",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "617470267",
            "telephone_number": "309-449-3321",
            "fax_number": "309-449-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPEDALE MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "ROSSI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "NELLO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-449-4338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": "1706400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hopedale Medical Complex",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hopedale Medical Complex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopedale, IL

Sources for this page

Verify at the official NPI Registry.