NPIMap

Organization Active NPI

Embracing Hospicecare of New Jersey,LLC

  • Community Based Hospice Care Agency
  • Wall, NJ
National Provider Identifier
1316943533
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
23087 Issued in NJ
Legal business name
EMBRACING HOSPICECARE OF NEW JERSEY,LLC
Practice address
3349 Route 138
Building D, Suite F
Wall, NJ 07719
Phone
(732) 974-2545
NPI assigned
Jun 22, 2005
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Mr. Richard A Tangolics
Title
Chief Operating Officer
Phone
(732) 974-2545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 23087 NJ Primary

Addresses

Primary practice location

3349 Route 138
Building D, Suite F
Wall, NJ 07719

Mailing address

3349 Route 138
Building D, Suite F
Wall, NJ 07719

Other identifiers 1

IdentifierTypeStateIssuer
0011517MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120411000886 NJ Part A Provider - Hospice 4183885502 Practice locations: Wall, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316943533. Details of each certification follow.

Hospice certification: CCN 311556

Legal name
EMBRACING HOSPICECARE OF NEW JERSEY,LLC
Doing business as
EMBRACING HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 27, 2003
Last certification
Sep 25, 2020
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Enrollment address
3349 Route 138
Building D, Suite F
Wall, NJ 07719-9671

Care Compare: Hospice

Medicare Care Compare
Listed as
Embracing Hospice Care of New JerseyCCN 311556 · All quality measures
Ownership
For-Profit
Certified
Jun 27, 2003
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
31D1063077Embracing Hospicecare3349 Route 138, Building D, Suite F, Wall, NJ 07719Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Locations

2101 State Route 34
Ste B
Wall Township, NJ 07719
Phone (732) 974-2545

3349 State Route 138
#D
Wall Township, NJ 07719
Phone (732) 974-2545

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Grant Bennett Individual 5% Or Greater Direct Ownership Interest Oct 27, 2009
Robert Platzman Individual Contracted Managing EmployeeMD; Feb 10, 2019
Reid Bennett Individual 5% Or Greater Direct Ownership Interest Oct 27, 2009
W-2 Managing Employee Oct 27, 2009
Donald M Micallef Individual Contracted Managing EmployeeMD; Jan 2, 2023
Richard Tangolics Individual 5% Or Greater Direct Ownership Interest Oct 27, 2009
Susan Froehlich Individual W-2 Managing EmployeeAd; Nov 29, 2004 10%
Lori Roberts Individual 5% Or Greater Direct Ownership Interest Oct 27, 2009

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

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1316943533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 ROUTE 138",
            "address_2": "BUILDING D, SUITE F",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "07719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 ROUTE 138",
            "address_2": "BUILDING D, SUITE F",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "07719",
            "telephone_number": "732-974-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACING HOSPICECARE OF NEW JERSEY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "TANGOLICS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "732-974-2545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NJ",
            "license": "23087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011517",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall, NJ

Sources for this page

Verify at the official NPI Registry.