Moments Hospice of St Cloud LLC
Organization Active NPI Community Based Hospice Care Agency · Saint Cloud, MN
NPI 1366907446 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1366907446
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- MOMENTS HOSPICE OF ST CLOUD LLC
- Practice address
- 2229 Roosevelt Rd Ste 1
Saint Cloud, MN 56301-5147 - Phone
- (320) 372-4300
- NPI assigned
- Feb 4, 2019
- Organization subpart
- No
Authorized official
- Name
- Eliyahu Jaffa
- Title
- Owner
- Phone
- (833) 467-7423
Owners & managing parties with NPI records 1
Affiliated clinicians 28
-
Michael Jon Beste, M.D.
-
Richard Luboga Byakika, M.D.
-
Brian John Dixon, MD
-
Kristi Rae Gebhardt, D.O.
-
Daniel Verdon Johnson, M.D.
-
Thomas Grant Krumme, M.D.
-
David W Laposky, MD
-
Brian Lewis, MD
-
Abby Jo Murray, MD
-
Kelsi K. Nelson, M.D.
-
Julie Kay Olson, M.D,
-
Scott Rahm, M.D.
-
Jared R Reese, MD
-
Susan Grace Rossi, M.D.
-
Susan Ann Yankovich, M.D.
-
Julie Kay Youngs, MD
Medicare Care Compare: Hospice
- Listed as
- Moments Hospice
- Ownership
- For-Profit
- Certified
- Aug 14, 2019
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospice certification: CCN 241608
- Legal name
- MOMENTS HOSPICE OF ST CLOUD LLC
- Doing business as
- MOMENTS HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 14, 2019
- Last certification
- Aug 14, 2019
- Ownership / control type
- Proprietary - Individual
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 11, 2018 in MN
- Enrollment address
- 2229 Roosevelt Rd
Ste 1
Saint Cloud, MN 56301-5147
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Travis Christopher Weber |
W-2 Managing Employee |
May 10, 2026 | |
| Eliyahu Jaffa |
5% Or Greater Direct Ownership Interest |
Dec 11, 2018 | 100% |
| Joseph Spurlock |
W-2 Managing Employee |
May 10, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190304000740 | MN | Part a Provider - Hospice | 7517206857 | Practice locations: Saint Cloud, MN; Brainerd, MN |
National Provider Directory
Locations
17021 Commercial Park Rd
Ste 8
Brainerd, MN 56401
Phone (320) 372-4300
2229 Roosevelt Rd
Ste 1
Saint Cloud, MN 56301
Phone (320) 372-4300
1030 4th St SE
Ste 108
Saint Cloud, MN 56304
Phone (320) 372-4300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
2229 Roosevelt Rd Ste 1
Saint Cloud, MN 56301-5147
Mailing address
820 Lilac Dr N Ste 210
Golden Valley, MN 55422-4754
Phone (952) 220-6002
Other names
- Moments Hospice
Other providers in Saint Cloud, MN
- Jocelyn Mohs
- Carin Molenaar
- Matthew Molenaar
- Cole Molitor
- Rose Mary Molitor
- Momentum Center,LLC
- Lindsey Monroe
- Alyssa Marie Monson
- Chelsea Montag
- Julia Vladimironva Montgomery
All providers in Saint Cloud, MN · Community Based Hospice Care Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.