NPIMap

Organization Active NPI

365 Hospice, LLC

  • Community Based Hospice Care Agency
  • State College, PA
National Provider Identifier
1376750398
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
365 HOSPICE, LLC
Practice address
1315 W College Ave Ste 303
State College, PA 16801-2776
Phone
(814) 946-5017
Fax
(814) 308-9947
NPI assigned
May 17, 2007
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Jonathan C Rezk
Title
Cfo
Phone
(814) 946-5017

Specialties & licenses 1

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

Addresses

Primary practice location

1315 W College Ave Ste 303
State College, PA 16801-2776

Mailing address

119 S Main St
Carrolltown, PA 15722-0477
Phone (814) 419-4901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000449 PA Part A Provider - Hospice 6406954841 Practice locations: State College, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376750398. Details of each certification follow.

Hospice certification: CCN 391691

Legal name
365 HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 22, 2007
Last certification
Jul 14, 2021
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Incorporated
May 3, 2007 in PA
Enrollment address
1315 W College Ave
Ste 303
State College, PA 16801-2776

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
365 Hospice LLCCCN 391691 · All quality measures
Ownership
For-Profit
Certified
Oct 22, 2007
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
365 Hospice LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1315 W College Ave
Ste 303
State College, PA 16801
Phone (518) 307-1990

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
George M Zlupko Individual Operational/Managerial ControlMedical Director May 20, 2024
Michael C Zlupko Individual Operational/Managerial ControlMedical Director May 20, 2024
John Rezk Individual 5% Or Greater Direct Ownership InterestCeo Jun 1, 2007 100%
Debbie Phillips Individual Operational/Managerial ControlPatient Care Administrator (Pca) May 20, 2024
Zane H Gates Individual Operational/Managerial ControlMedical Director May 20, 2024
Francesca Gildea Individual Operational/Managerial ControlPatient Care Administrator (Pca) May 20, 2024
Thomas Rezk Individual Operational/Managerial ControlDirector of Business Development May 20, 2024
Brandon M Roscoe Individual Operational/Managerial ControlMedical Director May 20, 2024
Jonathan C Rezk Individual Corporate OfficerCfo Jul 1, 2016
W-2 Managing EmployeeVP Finance/Board Member Aug 1, 2012
Operational/Managerial ControlCfo Aug 1, 2012
Brenda J Romanini Individual Operational/Managerial ControlExecutive Director Jul 9, 2024

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1376750398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S MAIN ST",
            "city": "CARROLLTOWN",
            "state": "PA",
            "postal_code": "157220477",
            "telephone_number": "814-419-4901",
            "fax_number": "814-419-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W COLLEGE AVE STE 303",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012776",
            "telephone_number": "814-946-5017",
            "fax_number": "814-308-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "365 HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-09-12",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "REZK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-946-5017"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.