NPIMap

Organization Active NPI

Serenity Hospice, LLC

Doing business as Breeze Hospice of Missouri

  • Community Based Hospice Care Agency
  • Chesterfield, MO
National Provider Identifier
1194478172
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SERENITY HOSPICE, LLC
Doing business as
Breeze Hospice of Missouri
Practice address
14410 Cazado Dr
Chesterfield, MO 63017-2111
Phone
(718) 612-2183
NPI assigned
Jan 31, 2022
Last updated
Jan 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Yosef Manne
Title
Ceo
Phone
(718) 612-2183

Specialties & licenses 1

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

Addresses

Primary practice location

14410 Cazado Dr
Chesterfield, MO 63017-2111

Mailing address

14410 Cazado Dr
Chesterfield, MO 63017-2111

Other names 1

  • Breeze Hospice of Missouri Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220513001759 MO Part A Provider - Hospice 9638556582 Practice locations: Ballwin, MO; Ste Genevieve, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194478172. Details of each certification follow.

Hospice certification: CCN 261671

Legal name
SERENITY HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 16, 2016
Last certification
Jun 27, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jan 27, 2022 in MO
Enrollment address
301 Sovereign CT
Ste 209
Ballwin, MO 63011-4435

Care Compare: Hospice

Medicare Care Compare
Listed as
Breeze Hospice of MissouriCCN 261671 · All quality measures
Ownership
For-Profit
Certified
Aug 16, 2016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

374 Market St
Ste Genevieve, MO 63670
Phone (314) 833-3180

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Lynn Anson Individual W-2 Managing EmployeeAdministrator Jan 2, 2024 100%
Baruch Jeremias Individual 5% Or Greater Indirect Ownership InterestTrustee of 10-26 Nationwide TR. Jan 1, 2023 37.5%
Mo Hospice Investments, LLC Organization, Saint Louis, MO LLC 5% Or Greater Direct Ownership Interest Mar 10, 2022 100%
Yosef Manne Individual 5% Or Greater Indirect Ownership InterestMember Mar 10, 2022 10%
Corporate OfficerCeo Mar 10, 2022 100%
Naftali Friedman Individual 5% Or Greater Indirect Ownership InterestMember Mar 10, 2022 5%
Chaim Dov Winter Individual 5% Or Greater Indirect Ownership InterestMember Mar 10, 2022 5%
10-26 Nationwide TR Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Jan 1, 2023 37.5%
Shawn Michael Gao Individual Contracted Managing EmployeeMedical Director May 1, 2022 100%
Menachem Winter Individual 5% Or Greater Indirect Ownership InterestMember Mar 10, 2022 5%
Judah Bienstock Individual 5% Or Greater Indirect Ownership InterestMember Jan 1, 2023 37.5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 39

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

View all 39

Change-of-ownership history 1

DateEventCounterparty
Mar 10, 2022 Change of OwnershipThis provider was the buyer Breeze Hospice of Missouri LLCCCN 261671, MO, NPI 1538537816

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1194478172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14410 CAZADO DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14410 CAZADO DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172111",
            "telephone_number": "718-612-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "MANNE",
        "authorized_official_first_name": "YOSEF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-612-2183"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breeze Hospice of Missouri",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.