NPIMap

Organization Active NPI

Endless Mountains Health Systems, Inc.

  • Critical Access Hospital
  • Montrose, PA
National Provider Identifier
1215918560
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
136701 Issued in PA
Legal business name
ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.
Practice address
100 Hospital Dr
Montrose, PA 18801-6402
Phone
(570) 278-3801
Fax
(570) 278-3648
NPI assigned
Nov 11, 2005
Last updated
May 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Mr. Rexford O. Catlin
Title
Ceo
Phone
(570) 278-3801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 136701 PA Primary

Addresses

Primary practice location

100 Hospital Dr
Montrose, PA 18801-6402

Mailing address

25 Grow Ave
Montrose, PA 18801-1106
Phone (570) 278-3801

Other identifiers 1

IdentifierTypeStateIssuer
01628205MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040720001091 PA Part B Supplier - Clinic/Group Practice 1456331677 Receives reassigned benefits from 13 practitioners
Practice locations: Montrose, PA
O20080202000009 PA Part A Provider - Critical Access Hospital 1456331677 Receives reassigned benefits from 1 practitioner
Practice locations: Montrose, PA
O20141001000181 PA Part B Supplier - Pharmacy 1456331677 Practice locations: Montrose, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215918560. Details of each certification follow.

Hospital certification: CCN 391306

Legal name
ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2004
Last certification
Oct 3, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 12, 1993 in PA
Enrollment address
100 Hospital Dr
Montrose, PA 18801-6402
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Endless Mountains Health SystemsCCN 391306 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

25 Grow Ave
Montrose, PA 18801
Phone (570) 278-3801

574 Grow Ave
Montrose, PA 18801

17382 State Route 11
Ste 3
New Milford, PA 18834

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Robert Housel Individual Corporate OfficerBoard Member Jan 1, 2016
Joseph M Speicher Individual Corporate OfficerBoard Member Jan 1, 2016
Loren Stone Individual Corporate OfficerCeo Jan 1, 2016
Corporate Director Jan 9, 2007
W-2 Managing Employee Jan 9, 2007
Chris Caterson Individual Corporate OfficerBoard Member Jan 1, 2016
Rexford O Catlin Individual Corporate OfficerBoard Member Jan 1, 2016
Corporate Director Jan 9, 2007
W-2 Managing Employee Jan 9, 2007
Lawrence Souder Individual Corporate OfficerBoard Member Jan 1, 2016
Eric Lewis Individual Corporate OfficerBoard Member Jan 1, 2016
Ihab Dana Individual Corporate OfficerBoard Member Jan 1, 2016
Corporate Director Jan 9, 1997

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

Affiliated clinicians 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1215918560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GROW AVE",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188011106",
            "telephone_number": "570-278-3801",
            "fax_number": "570-278-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188016402",
            "telephone_number": "570-278-3801",
            "fax_number": "570-278-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "CATLIN",
        "authorized_official_first_name": "REXFORD",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-278-3801",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "PA",
            "license": "136701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01628205",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, PA

Sources for this page

Verify at the official NPI Registry.