NPIMap

Organization Active NPI

Hospice of Palm Beach County, Inc.

  • Community Based Hospice Care Agency
  • West Palm Beach, FL
National Provider Identifier
1538174263
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
5027096 Issued in FL
Legal business name
HOSPICE OF PALM BEACH COUNTY, INC.
Practice address
5300 East Ave
West Palm Beach, FL 33407-2387
Phone
(561) 848-5200
NPI assigned
Jul 30, 2006
Last updated
Mar 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Authorized official

Name
Mr. David C Fielding
Title
President and Ceo
Phone
(561) 848-5200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 5027096 FL Primary
Inpatient Hospice 315D00000X 5027096 FL

Addresses

Primary practice location

5300 East Ave
West Palm Beach, FL 33407-2387

Mailing address

5300 East Ave
West Palm Beach, FL 33407-2387
Phone (561) 848-5200

Other identifiers 1

IdentifierTypeStateIssuer
087516300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000009 FL Part B Supplier - Clinic/Group Practice 9830082973 Receives reassigned benefits from 10 practitioners
Practice locations: West Palm Beach, FL
O20080503000023 FL Part A Provider - Hospice 9830082973 Practice locations: West Palm Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538174263. Details of each certification follow.

Hospice certification: CCN 101512

Legal name
HOSPICE OF PALM BEACH COUNTY, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 20, 1984
Last certification
Jul 13, 2018
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Feb 27, 1978 in FL
Enrollment address
5300 East Avenue
West Palm Beach, FL 33407-2387

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Palm Beach County IncCCN 101512 · All quality measures
Ownership
Non-Profit
Certified
Jun 20, 1984
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0286627Hospice of Palm Beach County Inc5300 East Ave, West Palm Beach, FL 33407Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Palm Beach County2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

550 W Cypress Creek Rd
Ste 370
Ft Lauderdale, FL 33309
Phone (954) 267-3800

5300 East Ave
West Palm Beach, FL 33407
Phone (561) 227-5177

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Christy Hendricks Individual Corporate OfficerChief Legal Officer Apr 3, 2025
Katherine L Brazzale Individual Corporate OfficerChief Medical Director Apr 3, 2025
W-2 Managing EmployeeMD; Apr 3, 2025
Trustbridge Inc. Organization, West Palm Beach, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 4, 2014 100%
Saida Bouhamid Individual Corporate OfficerCfo Apr 3, 2025
Tarrah L Lowry Individual Corporate OfficerCoo Aug 2, 2021
Operational/Managerial Control May 1, 2024
Thomas Burns Individual Corporate DirectorTreasurer Apr 3, 2025
William Quinn Individual Corporate DirectorChairman Apr 3, 2025
Mark Cook Individual Corporate DirectorVice Chair Apr 3, 2025
Edward a Maxwell Individual W-2 Managing EmployeeAd; Apr 3, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1538174263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072387",
            "telephone_number": "561-848-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072387",
            "telephone_number": "561-848-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF PALM BEACH COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "FIELDING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "561-848-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "5027096",
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "FL",
            "license": "5027096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087516300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.