Active NPI
Bristol Hospice - Green Bay, L.L.C.
- Community Based Hospice Care Agency
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- BRISTOL HOSPICE - GREEN BAY, L.L.C.
- Practice address
- 2450 Velp Ave Ste 101
Green Bay, WI 54303-6593 - Phone
- (920) 278-2499
- Fax
- (920) 328-9052
- NPI assigned
- Mar 26, 2021
- Last updated
- Feb 27, 2026
- Organization subpart
- Yes
- Parent organization
- BRISTOL HOSPICE, L.L.C.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
2450 Velp Ave Ste 101
Green Bay, WI 54303-6593
Mailing address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220314000964 | WI | Part A Provider - Hospice | 6002201894 | Practice locations: Green Bay, WI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1356928154. Details of each certification follow.
Hospice certification: CCN 521610
- Legal name
- BRISTOL HOSPICE - GREEN BAY, L.L.C.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 17, 2022
- Last certification
- May 17, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jan 28, 2021 in DE
- Enrollment address
- 2450 Velp Ave
Ste 101
Green Bay, WI 54303-6593
Care Compare: Hospice
Medicare Care Compare- Listed as
- Bristol Hospice Green Bay
- Ownership
- For-Profit
- Certified
- May 17, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2243060 | Bristol Hospice - Green Bay, LLC | Certificate of waiver | Nov 15, 2027 |
National Provider Directory
National Provider Directory- Part of
- Bristol Hospice LLC
Locations
2450 Velp Ave
Ste 101
Green Bay, WI 54303
Phone (801) 325-0175
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc | 5% Or Greater Indirect Ownership Interest | Jan 28, 2021 | 100% |
| Alex Edward Mauricio | Corporate Officer | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2023 | ||
| Webster Equity Partners Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 25, 2022 | 69.8% |
| John Charles Garbarino | Corporate Officer | Jan 28, 2021 | |
| Corporate Director | Jan 28, 2021 | ||
| Webster Equity Partners IV Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 25, 2022 | 5.72% |
| Michael Derrick | Corporate Officer | Sep 1, 2023 | |
| Corporate Director | Sep 1, 2023 | ||
| Betty J Brennan | Corporate Director | Jul 13, 2018 | |
| Bristol Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | Jan 28, 2021 | 100% |
| Scott R Schinschke | Contracted Managing Employee | May 15, 2021 | |
| Hyrum Kirton | Corporate Director | Oct 26, 2020 | |
| Aware Super Pty, LTD. | 5% Or Greater Indirect Ownership Interest | Jan 24, 2022 | 8.28% |
| Bristol Hospice, L.L.C. | 5% Or Greater Direct Ownership Interest | Jan 28, 2021 | 100% |
| Ally Schauer | W-2 Managing Employee | Jul 21, 2025 | |
| Bristol Hospice Topco Inc | 5% Or Greater Indirect Ownership Interest | Jan 28, 2021 | 100% |
| David a Malm | Corporate Officer | Jan 28, 2021 | |
| Corporate Director | Jan 28, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Pulaski, WI
- NPI 1407951130
Contracted Managing Employee
Facilities with the same owner 52
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Madison, WI
- NPI 1992382733
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bangor, ME
- NPI 1336916469
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bend, OR
- NPI 1356916845
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Plymouth Meeting, PA
- NPI 1356118467
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Merced, CA
- NPI 1487603452
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- North Charleston, SC
- NPI 1326866963
Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Des Plaines, IL
- NPI 1104548478
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Springfield, OR
- NPI 1568962033
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Atlanta, GA
- NPI 1558663872
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Healthcare Services
- Community Based Hospice Care Agency
- Honolulu, HI
- NPI 1811045594
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Hospice - Inland Empire
- Community Based Hospice Care Agency
- Riverside, CA
- NPI 1043683170
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba All Saints Hospice, Inc.
- Community Based Hospice Care Agency
- Ontario, CA
- NPI 1013318112
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
Practitioners & affiliated clinicians
Affiliated clinicians 24
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Appleton, WI
- NPI 1942720727
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772150400000",
"number": "1356928154",
"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": "801-325-0175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 VELP AVE STE 101",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543036593",
"telephone_number": "920-278-2499",
"fax_number": "920-328-9052"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRISTOL HOSPICE - GREEN BAY, L.L.C.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
"enumeration_date": "2021-03-26",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.