NPIMap

Organization Active NPI

Bridge Hospice Solano LLC

  • Community Based Hospice Care Agency
  • Fairfield, CA
National Provider Identifier
1205458148
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BRIDGE HOSPICE SOLANO LLC
Practice address
1261 Travis Blvd Ste 250
Fairfield, CA 94533-4825
Phone
(707) 376-8118
NPI assigned
May 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Jeff Mongonia
Title
Ceo
Phone
(858) 251-4242

Specialties & licenses 1

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

Addresses

Primary practice location

1261 Travis Blvd Ste 250
Fairfield, CA 94533-4825

Mailing address

3636 Nobel Dr Ste 450
San Diego, CA 92122-1062
Phone (858) 251-4242

Other names 1

  • Bridge Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210609001572 CA Part A Provider - Hospice 0840690020 Practice locations: Fairfield, CA

Hospice certification: CCN B41651

Legal name
BRIDGE HOSPICE SOLANO LLC
Doing business as
BRIDGE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 9, 2021
Last certification
Sep 9, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
May 14, 2020 in CA
Enrollment address
1261 Travis Blvd
Ste 250
Fairfield, CA 94533-4825

Care Compare: Hospice

Medicare Care Compare
Listed as
Bridge HospiceCCN B41651
Certified
Sep 9, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2217029Bridge Hospice Solano LLC Dba Bridge Hospice1261 Travis Blvd Ste 250, Fairfield, CA 94533Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory

Locations

1261 Travis Blvd
Ste 250
Fairfield, CA 94533
Phone (707) 376-8118

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
Jennifer Robinson Individual Contracted Managing EmployeeAdministrator Designee Aug 23, 2024
Operational/Managerial ControlAdministrator Designee Aug 23, 2024
Janet McInnes Individual Contracted Managing EmployeeDirector of Patient Care Services Sep 9, 2025
Operational/Managerial ControlDirector of Patient Care Services Sep 9, 2025
Bridge Group Holdco LLC Organization, San Diego, CA Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 14, 2020 100%
Patrick Aaron Shea Individual Contracted Managing EmployeeMD; Feb 1, 2026
Vincent Castaldo Individual Corporate OfficerCfo May 29, 2024
Ahp HH&H Holdco LLC Organization, New York, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 14, 2020 82.8%
Jeffrey W Mongonia Individual Corporate OfficerCeo Apr 14, 2023
Jennifer L Prouty Boertje Individual Contracted Managing EmployeeDPCS Designee Jan 25, 2025
Operational/Managerial ControlDPCS Designee Jan 25, 2025
Bridge Group HH Inc Organization, San Diego, CA Created for acquisition, Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 14, 2020 100%
Operational/Managerial Control May 14, 2020
Cherese M Holland Individual Contracted Managing EmployeeAd; Feb 13, 2025
Operational/Managerial ControlAdministrator Feb 13, 2025

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 11

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

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": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1205458148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 NOBEL DR STE 450",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221062",
            "telephone_number": "858-251-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 TRAVIS BLVD STE 250",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334825",
            "telephone_number": "707-376-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE HOSPICE SOLANO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "MONGONIA",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-251-4242"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.