NPIMap

Organization Active NPI

Ashlar Home Health and Hospice Services, LLC

  • Community Based Hospice Care Agency
  • Elizabethtown, PA
National Provider Identifier
1497280788
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
17211601 Issued in PA
Legal business name
ASHLAR HOME HEALTH AND HOSPICE SERVICES, LLC
Practice address
1 Masonic Dr
Elizabethtown, PA 17022-2199
Phone
(717) 367-1121
NPI assigned
Apr 25, 2017
Organization subpart
Yes
Parent organization
MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Justin Wolgemuth
Title
Senior VP of Operations
Phone
(717) 367-1121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 17211601 PA Primary

Addresses

Primary practice location

1 Masonic Dr
Elizabethtown, PA 17022-2199

Mailing address

1 Masonic Dr
Elizabethtown, PA 17022-2199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170710000067 PA Part A Provider - Hospice 2264714666 Practice locations: Elizabethtown, PA

Hospice certification: CCN 391721

Legal name
ASHLAR HOME HEALTH AND HOSPICE SERVICES LLC
Doing business as
MASONIC VILLAGE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 19, 2010
Last certification
Oct 27, 2017
Ownership / control type
Non-Profit - Private
Organization structure
LLCNon-profit
Enrollment address
98 Masonic Dr
Ste 101
Elizabethtown, PA 17022-2574

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
Masonic Village HospiceCCN 391721
Ownership
Non-Profit
Certified
Jan 19, 2010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ashlar Home Health Hospice4 organizations share this tax ID, including this one
Part of
Masonic Home of PA

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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
Patrick J Sampsell Individual Corporate OfficerSecretary Dec 29, 2021
Brenda Spence Individual W-2 Managing EmployeeDirector of Resident Accounts Jun 1, 2017
William Kingsbury Individual Corporate OfficerBoard of Directors/Ceo Jan 1, 2020
Adrienne Staudenmayer Individual Corporate OfficerCoo Dec 29, 2021
Justin E Wolgemuth Individual Corporate OfficerSenior VP Jan 1, 2020
John F Pyfer Individual Corporate DirectorBoard of Directors Jan 1, 2020
Pamela Formica Individual Corporate OfficerTreasurer/Cfo Jan 1, 2020
John J Mast Individual Contracted Managing EmployeeMD; Jun 9, 2021
Debra a Brockman Individual Corporate DirectorBoard Member Jun 1, 2017
Masonic Villages of the Grand Lodge of Pennsylvania Organization, Elizabethtown, PA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2017 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2017 Change of OwnershipThis provider was the buyer Masonic Village at ElizabethtownCCN 391721, PA, NPI 1932453867

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1497280788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MASONIC DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MASONIC DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222199",
            "telephone_number": "717-367-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAR HOME HEALTH AND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA",
        "enumeration_date": "2017-04-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "WOLGEMUTH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "SENIOR VP OF OPERATIONS",
        "authorized_official_telephone_number": "717-367-1121"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PA",
            "license": "17211601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

Verify at the official NPI Registry.