Wenatchee Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

WENATCHEE HOSPICE LLC

Doing business as

Advanced Hospice Northwest of Wenatchee

Practice address

285 Technology Center Way Ste 108
Wenatchee, WA 98801-8120

Phone

(509) 663-9585

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Matthew D Ham

Title

Coo

Phone

(480) 710-7323

Specialties & licenses 1

Addresses

Other names 1

• Advanced Hospice Northwest of Wenatchee Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Hospice certification: CCN 501551

Legal name

WENATCHEE HOSPICE LLC

Doing business as

ADVANCED HOSPICE NORTHWEST OF WENATCHEE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 18, 2023

Last certification

Jun 28, 2023

Organization structure

LLCProprietary

Incorporated

Dec 1, 2021 in WA

Enrollment address

285 Technology Center Way
Ste 108
Wenatchee, WA 98801-8120

Listed as

Advanced Hospice Northwest of WenatcheeCCN 501551 · All quality measures

Certified

Jul 18, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

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

Owners & managing parties with NPI records 1

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

• Jonathan S Kim, M.D.

  • Emergency Medicine Physician
  • Wenatchee, WA
  • NPI 1023270774

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 1

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

• Wenatchee Home Health LLC

  • Home Health Agency
  • Wenatchee, WA
  • NPI 1366962953

  Stride Health Care

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan S Kim, M.D.

  • Emergency Medicine Physician
  • Wenatchee, WA
  • NPI 1023270774
  NPD (past)

Affiliated clinicians 2

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

• Makena Ackerman, ARNP

  • Family Nurse Practitioner
  • Wenatchee, WA
  • NPI 1598500936

  Hospice

  Care Compare affiliation
• Dragana Stojsic-Garetson, NP

  • Nurse Practitioner
  • Wenatchee, WA
  • NPI 1710400122

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1497479703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 TECHNOLOGY CENTER WAY STE 108",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988018120",
            "telephone_number": "509-663-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 TECHNOLOGY CENTER WAY STE 108",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988018120",
            "telephone_number": "509-663-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENATCHEE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-710-7323",
        "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": [
        {
            "organization_name": "Advanced Hospice Northwest of Wenatchee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wenatchee Clinic Pharmacy
• Wenatchee Dental
• Wenatchee Dental Arts
• Wenatchee Emergency Physicians
• Wenatchee Home Health LLC
• Wenatchee Midwife Service
• Wenatchee Midwife Service & Childbirth Center
• Wenatchee Mobility Services Inc.
• Wenatchee Relief, Inc.
• Wenatchee School District

• Community Based Hospice Care Agency in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Community Based Hospice Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.

Verify at the official NPI Registry.