Moments Hospice of Eau Claire LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MOMENTS HOSPICE OF EAU CLAIRE LLC

Practice address

2263 East Ridge Center
Eau Claire, WI 54701

Phone

(763) 205-3600

NPI assigned

Sep 13, 2019

Organization subpart

No

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

Authorized official

Name

Eliyahu Jaffa

Title

President

Phone

(715) 800-0908

Specialties & licenses 1

Addresses

Other names 1

• Moments Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Hospice certification: CCN 521604

Legal name

MOMENTS HOSPICE OF EAU CLAIRE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 23, 2020

Last certification

Apr 23, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jun 13, 2019 in WI

Enrollment address

2263 Eastridge Ctr
Eau Claire, WI 54701-3410

Listed as

Moments Hospice of Eau ClaireCCN 521604

Ownership

For-Profit

Certified

Apr 23, 2020

Medicare certification status

ActiveFrom the Provider of Services file

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.

Practitioners 1

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

• Lacey Darlene Lake Foreman, CRNP

  • Nurse Practitioner
  • Golden Valley, MN
  • NPI 1922510635
  NPD (past)

Affiliated clinicians 4

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

• David Juston Colvin, M.D.

  • Family Medicine Physician
  • Shell Lake, WI
  • NPI 1023010592

  Hospice

  Care Compare affiliation
• Louay O Danial, MD

  • Family Medicine Physician
  • Park Falls, WI
  • NPI 1316041676

  Hospice

  Care Compare affiliation
• Ryan McFarland, MD

  • Family Medicine Physician
  • Hudson, WI
  • NPI 1295183713

  Hospice

  Care Compare affiliation
• Sarah McFarland, MD

  • Family Medicine Physician
  • Hudson, WI
  • NPI 1386093979

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1194375915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N STE 210",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224754",
            "telephone_number": "612-655-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2263 EAST RIDGE CENTER",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "763-205-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTS HOSPICE OF EAU CLAIRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "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"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moments Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moments Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanajakshi Mogulla, M.D.
• Muhanad Mohamed, M.D
• Rajiv Mohan, MD
• Catherine Mohr
• Theodore E Mollerud
• Alison Mompier
• Benjamin Mompier, CAPSW
• Eric Monahan, M.D.
• Janelle Moneypenny, SAC-IT
• Stanley James Monson, OD

• Community Based Hospice Care Agency in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Community Based Hospice Care Agency in Wisconsin

• 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.