Bridgeway Hospice LLC

Organization Active NPI Community Based Hospice Care Agency · Buda, TX

NPI 1255934980 · NPPES record last updated Jun 2, 2026

Key facts

NPI
1255934980
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
Legal business name
BRIDGEWAY HOSPICE LLC
Practice address
825 Main St Ste 120
Buda, TX 78610-3273
Phone
(512) 523-5265
Fax
(512) 361-0030
NPI assigned
Nov 17, 2020
Organization subpart
No

Authorized official

Name
Edward Wilmore
Title
Coo
Phone
(512) 565-6182

Owners & managing parties with NPI records 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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

Medicare Care Compare: Hospice

Listed as
Bridgeway Hospice, LLC. CCN 971719
Ownership
For-Profit
Certified
Dec 3, 2021

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Hospice certification: CCN 971719

Legal name
BRIDGEWAY HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 3, 2021
Last certification
Dec 3, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLC · Proprietary
Incorporated
Oct 29, 2020 in TX
Enrollment address
825 Main St
Ste 120
Buda, TX 78610-3273

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Diego Moreno
Individual
Corporate Director
Medical Director
Feb 1, 2022 100%
Brandis Wilmore
Individual
5% Or Greater Direct Ownership Interest
President
Oct 29, 2020 100%
Edward Wilmore
Individual
Operational/Managerial Control
Cfo
Apr 7, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211012000511 TX Part a Provider - Hospice 5991103624 Practice locations: Buda, TX

National Provider Directory

Locations

825 Main St
Ste 140
Buda, TX 78610
Phone (512) 295-7000

Specialties & licenses

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

Addresses

Primary practice location

825 Main St Ste 120
Buda, TX 78610-3273

Mailing address

825 Main St Ste 120
Buda, TX 78610-3273
Phone (512) 523-5265

Other providers in Buda, TX

All providers in Buda, TX · Community Based Hospice Care Agency in Texas

Sources for this page

Verify at the official NPI Registry.