NPIMap

Constellation Home Care LLC

Organization Active NPI Community Based Hospice Care Agency · Orange, CT

NPI 1417239088 · NPPES record last updated Sep 9, 2011

Key facts

NPI
1417239088
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
License
0032 (CT)
Legal business name
CONSTELLATION HOME CARE LLC
Practice address
240 Indian River Rd
Orange, CT 06477-3649
Phone
(203) 497-3888
NPI assigned
Sep 9, 2011
Organization subpart
No

Authorized official

Name
Ms. Joane Walsh
Title
Ceo
Phone
(203) 845-8000

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 1

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

Affiliated clinicians 166

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

View all 166

Medicare Care Compare: Hospice

Listed as
Constellation Home Care CCN 071542
Ownership
For-Profit
Certified
Jun 13, 2012
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Hospice certification: CCN 071542

Legal name
CONSTELLATION HOME CARE LLC
Doing business as
CONSTELLATION HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 13, 2012
Last certification
May 5, 2022
Ownership / control type
Proprietary - Other
Organization structure
LLC · Proprietary
Incorporated
Jun 13, 2012 in CT
Enrollment address
240 Indian River Rd
Orange, CT 06477-3649

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Marvin J. Ostreicher
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 31.78%
Andrew William Lyons
Individual 		W-2 Managing Employee
MD;		 Feb 1, 2020
David Ostreicher
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 5%
Barry Bokow
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 10%
Marc E Ostreicher
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 16.11%
Elizabeth Almeida
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 10%
Ira Geffner
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 6%
Yitzchok Steg
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 16.11%
Constellation Health Services LLC
Organization · Norwalk, CT
LLC, Holding company, For-profit 		Other May 18, 2009 100%
Jason a Creutzmann
Individual 		Corporate Officer
Administrator		 Jun 27, 2016 100%
W-2 Managing Employee
Administrator		 Jun 27, 2016 100%
Rebecca Lopiansky
Individual 		5% Or Greater Direct Ownership Interest Apr 14, 2011 5%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111130000027 CT Part a Provider - Hospice 0941388078 Practice locations: Norwalk, CT; Rocky Hill, CT; Orange, CT

National Provider Directory

Tax ID family
Constellation Home Care LLC (2 organizations share this tax ID)

Locations

2080 Silas Deane Hwy
Ste 305
Rocky Hill, CT 06067
Phone (203) 845-8000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0032 CT Yes

Addresses

Primary practice location

240 Indian River Rd
Orange, CT 06477-3649

Mailing address

14 Westport Ave
Norwalk, CT 06851-3915
Phone (203) 845-8000

Other names

  • Constellation Hospice Doing business as

Other providers in Orange, CT

All providers in Orange, CT · Community Based Hospice Care Agency in Connecticut

Sources for this page

Verify at the official NPI Registry.