Organization Active NPI

Bristol Hospice - Pierce, L.L.C.

  • Community Based Hospice Care Agency
  • Tacoma, WA
National Provider Identifier
1215689237
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BRISTOL HOSPICE - PIERCE, L.L.C.
Practice address
1401 S Union Ave Ste B
Tacoma, WA 98405-1901
Phone
(253) 215-9416
NPI assigned
Jan 20, 2022
Last updated
Sep 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BRISTOL HOSPICE, L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Authorized official

Name
Mr. Alex Mauricio
Title
President and Ceo
Phone
(801) 325-0175

Specialties & licenses 1

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

Addresses

Primary practice location

1401 S Union Ave Ste B
Tacoma, WA 98405-1901

Mailing address

206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 250-1753

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250411002434 WA Part A Provider - Hospice 2668996596 Practice locations: Tacoma, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215689237. Details of each certification follow.

Hospice certification: CCN 501562

Legal name
BRISTOL HOSPICE - PIERCE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 2, 2025
Last certification
Jul 2, 2025
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Enrollment address
1401 S Union Ave
Ste B
Tacoma, WA 98405-1901

Care Compare: Hospice

Medicare Care Compare
Listed as
Bristol Hospice - Pierce, LLCCCN 501562 · All quality measures
Certified
Jul 2, 2025
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
50D2319425Bristol Hospice - Pierce, LLC1401 S Union Ave Ste B, Tacoma, WA 98405Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Bristol Hospice LLC

Locations

1011 E Main
Ste 451
Puyallup, WA 98372

1401 S Union Ave
Ste B
Tacoma, WA 98405
Phone (253) 215-9416

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Bristol Hospice Holdings Inc Organization, Salt Lake City, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 19, 2025 100%
Alex Edward Mauricio Individual Corporate OfficerPresident & Ceo Feb 19, 2025 100%
Corporate DirectorDirector Feb 19, 2025
Webster Equity Partners Bristol CF LP Organization, Waltham, MA For-profit, Private equity company 5% Or Greater Indirect Ownership Interest Feb 19, 2025 69.8%
John Charles Garbarino Individual Corporate OfficerSecretary/Treasurer Feb 19, 2025
Corporate DirectorDirector Feb 19, 2025
Webster Equity Partners IV Bristol CF LP Organization, Waltham, MA For-profit, Private equity company 5% Or Greater Indirect Ownership Interest Feb 19, 2025 5.72%
Michael Derrick Individual Corporate OfficerCfo Feb 19, 2025
W-2 Managing EmployeeCfo Feb 19, 2025
Betty J Brennan Individual Corporate DirectorDirector Jul 13, 2018
Bristol Ultimate Holdco, LP Organization, Salt Lake City, UT Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 19, 2025 100%
Hyrum Kirton Individual Corporate DirectorDirector Oct 26, 2020
Alex P Conte Individual W-2 Managing EmployeeAd; Dec 17, 2025
Aware Super Pty, LTD. Organization, Sydney, IN LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Jan 24, 2022 8.28%
Jordan Nagle Individual Contracted Managing EmployeeMD; Feb 19, 2025
Bristol Hospice, L.L.C. Organization, Salt Lake City, UT LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 15, 2025 100%
Bristol Hospice Topco Inc Organization, Salt Lake City, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 19, 2025 100%
David a Malm Individual Corporate OfficerVice President Feb 19, 2025
Corporate DirectorDirector Feb 19, 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 52

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

View all 52

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 1

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": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1215689237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-250-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S UNION AVE STE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051901",
            "telephone_number": "253-215-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPICE - PIERCE, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
        "enumeration_date": "2022-01-20",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "801-325-0175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.