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Organization Active NPI

Cornerstone Hospice & Palliative Care Inc

  • Community Based Hospice Care Agency
  • Tavares, FL
National Provider Identifier
1619028313
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
5019096 Issued in FL
Legal business name
CORNERSTONE HOSPICE & PALLIATIVE CARE INC
Practice address
2445 Lane Park Rd
Tavares, FL 32778-9648
Phone
(352) 343-1341
Fax
(352) 343-0325
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Crystal Bucciarelli
Title
VP, Legal Services
Phone
(813) 871-8075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 5019096 FL Primary

Addresses

Primary practice location

2445 Lane Park Rd
Tavares, FL 32778-9648

Mailing address

2445 Lane Park Rd
Tavares, FL 32778-9648
Phone (352) 343-1341

Other identifiers 2

IdentifierTypeStateIssuer
087526100MedicaidFL
U30OtherBLUE CROSSBLUE SHIELD

Other names 1

  • Hospice of Lake & Sumter Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090724000643 FL Part A Provider - Hospice 5597818435 Practice locations: Clermont, FL; The Villages, FL; Tavares, FL; Sumterville, FL; Sebring, FL; Orlando, FL; Ocoee, FL; Lakeland, FL

Hospice certification: CCN 101525

Legal name
CORNERSTONE HOSPICE & PALLIATIVE CARE INC
Doing business as
CORNERSTONE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 3, 1986
Last certification
Jan 28, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 1988 in FL
Enrollment address
2445 Lane Park Road
Tavares, FL 32778-9648

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Lake & Sumter IncCCN 101525
Ownership
For-Profit
Certified
Mar 3, 1986
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1200 Oakley Seaver Dr
Ste 212
Clermont, FL 34711

2100 Oakley Seaver Dr
Clermont, FL 34711

3283 S John Young Pkwy
Ste Iandj
Kissimmee, FL 34746

2140 E Road 540A
Lakeland, FL 33813
Phone (863) 647-2313

1300 Citizens Blvd
Ste 265
Leesburg, FL 34748

8007 S Orange Ave
Orlando, FL 32809

8009 S Orange Ave
Orlando, FL 32809

231 US 27 N
Sebring, FL 33870

209 N Ridgewood Dr
Sebring, FL 33870

2452 CR 526E
Sumterville, FL 33585

4215 County Road 561
Tavares, FL 32778
Phone (352) 742-6813

601 Casa Bella
The Villages, FL 32162

2590 Havendale Blvd NW
Winter Haven, FL 33881

Ownership & related parties

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
William R Mask Individual Corporate DirectorBoard Member Jan 1, 2013
Charles O Lee Individual Corporate OfficerCfo Jan 26, 2012
W-2 Managing EmployeeCeo Jan 26, 2012
Mark Starcher Individual Corporate Director Oct 1, 2014
Todd a Webb Individual Corporate OfficerCfo Dec 5, 2016
Rhonda G White Individual Corporate OfficerCoo Mar 1, 2014
Valerie Zolman Individual W-2 Managing Employee Oct 1, 2019
Tige R Buchanan Individual Corporate Director Sep 30, 2015
Wendy Y Terry Individual Corporate DirectorBoard Member Jan 1, 2013
Cornerstone Hospice & Palliative Care Inc Organization, Tavares, FL Corporation 5% Or Greater Direct Ownership Interest Jul 9, 2009
Operational/Managerial Control Jul 9, 2009 100%
Robert P Adrid Individual Corporate DirectorBoard Member Jan 1, 2013
James Novell Individual Corporate DirectorBoard Member Jan 1, 2013

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cornerstone Hospice and Palliative Care of Georgia, LLCMarietta, GA, CCN 851526 Hospice Operational/Managerial Control Mar 18, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1619028313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789648",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789648",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HOSPICE & PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "BUCCIARELLI",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VP, LEGAL SERVICES",
        "authorized_official_telephone_number": "813-871-8075"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "5019096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087526100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "U30",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Lake & Sumter",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.