NPIMap

Organization Active NPI

Merrimack Valley Hospice, Inc.

  • Community Based Hospice Care Agency
  • Malden, MA
National Provider Identifier
1508413733
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MERRIMACK VALLEY HOSPICE, INC.
Practice address
178 Savin St Ste 300
Malden, MA 02148-2329
Phone
(978) 552-4159
NPI assigned
Aug 22, 2019
Organization subpart
Yes
Parent organization
MERRIMACK VALLEY HOSPICE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Karen Gomes, RN, MBA
Title
President
Phone
(978) 552-4000

Specialties & licenses 1

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

Addresses

Primary practice location

178 Savin St Ste 300
Malden, MA 02148-2329

Mailing address

360 Merrimack St Ste 9
Lawrence, MA 01843-1764
Phone (978) 552-4000

Other names 1

  • Hallmark Health Hospice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090506000319 MA Part A Provider - Hospice 3870665268 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Haverhill, MA; Lowell, MA

Hospice certification: CCN 221508

Legal name
TUFTS MEDICINE CARE AT HOME, INC.
Doing business as
TUFTS MEDICINE CARE AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 25, 1985
Last certification
Mar 5, 2020
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Sep 19, 1988 in MA
Enrollment address
847 Rogers St
Ste 201
Lowell, MA 01852-4345

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Tufts Medicine Care at HomeCCN 221508
Ownership
Non-Profit
Certified
Sep 25, 1985
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Tufts Medicine Care at Home

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kara Doyle Individual Corporate DirectorTrustee Aug 13, 2019
Bernice M Burkarth Individual W-2 Managing EmployeeMD; Mar 6, 2018
Tufts Medicine Care at Home Parent, Inc. Organization, Lowell, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 19, 1988 100%
5% Or Greater Security Interest Sep 19, 1988 100%
Raymond H Lewis Individual Corporate Director May 27, 2021
Patricia a O'Brien Individual Corporate Officer May 1, 2023
Corporate Director May 1, 2023
W-2 Managing EmployeeAd; May 1, 2023
Michael Dandorph Individual Corporate Director Mar 26, 2020
Daniel a Hayes Individual Corporate DirectorTrustee Jul 19, 2007
Tufts Medicine, Inc Organization, Burlington, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Bobby Tugbiyele Individual Corporate Director May 23, 2024
Eda George Individual Corporate DirectorTrustee Oct 1, 2018
Scott a Collins Individual Corporate DirectorTrustee Chair May 21, 2009
Vivian Stameris Individual W-2 Managing EmployeeSenior Director of Finance Jan 8, 2024

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1508413733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST STE 9",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431764",
            "telephone_number": "978-552-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 SAVIN ST STE 300",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021482329",
            "telephone_number": "978-552-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK VALLEY HOSPICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERRIMACK VALLEY HOSPICE, INC.",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-552-4000",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hallmark Health Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.