NPIMap

Organization Active NPI

Hopedale Medical Foundation

Doing business as Hopedale Medical Complex

  • Medicare Defined Swing Bed Hospital Unit
  • Hopedale, IL
National Provider Identifier
1194857490
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
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
Mar 12, 2007
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
Medicare Defined Swing Bed Hospital Unit 275N00000X 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
O20080502000431 IL Part A Provider - Critical Access Hospital 1153363577 Receives reassigned benefits from 1 practitioner
Practice locations: Hopedale, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194857490. Details of each certification follow.

Hospital certification: CCN 14Z330

Legal name
HOPEDALE MEDICAL FOUNDATION
Doing business as
HOPEDALE MEDICAL COMPLEX
Organization structure
OtherNon-profit
Incorporated
Jun 7, 1961 in IL
Enrollment address
107 Tremont St
Hopedale, IL 61747-7525
Other Hospital Practice Location

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).

National Provider Directory

National Provider Directory
Tax ID family
Hopedale Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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 Officer 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 Officer Jan 1, 2023
Christopher Campbell Individual Corporate Officer Jan 1, 2023
Thomas C Hieser Individual Corporate Officer May 30, 1997
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 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 6

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1194857490",
    "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": "2007-03-12",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "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.