NPIMap

Monument Health Home Plus, LLC

Organization Active NPI Inpatient Hospice · Rapid City, SD

NPI 1639629256 · NPPES record last updated Aug 3, 2022

Key facts

NPI
1639629256
Entity type
Organization (NPI type 2)
Primary specialty
Inpatient Hospice 315D00000X
Legal business name
MONUMENT HEALTH HOME PLUS, LLC
Practice address
224 Elk St
Rapid City, SD 57701-7359
Phone
(605) 755-7710
Fax
(605) 755-7780
NPI assigned
Oct 6, 2016
Organization subpart
Yes
Parent organization (as reported)
MONUMENT HEALTH HOME PLUS, LLC

Authorized official

Name
Michael Tilles
Title
President Monument Health Home Plus
Phone
(605) 519-1179

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Owners & managing parties with NPI records 5

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

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 10

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.

Change of ownership 1

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

Facilities with the same owner 18

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

Affiliated clinicians 17

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

Medicare Care Compare: Hospice

Listed as
Monument Health Home Plus Hospice CCN 431501
Ownership
For-Profit
Certified
May 21, 1986
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SD

Hospice certification: CCN 431501

Legal name
MONUMENT HEALTH HOME PLUS LLC
Doing business as
MONUMENT HEALTH HOME PLUS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 21, 1986
Last certification
Oct 30, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLC · Non-profit
Incorporated
Jul 1, 2016 in SD
Enrollment address
224 Elk St
Rapid City, SD 57701-7359

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ruta P Davidson
Individual 		Operational/Managerial Control
President & Ceo		 Aug 18, 2018 100%
Michelle Sieveke
Individual 		W-2 Managing Employee
Director		 Jul 11, 2017 50%
Operational/Managerial Control
Director		 Jul 1, 2017 50%
Andrea Kristine Baier
Individual 		Contracted Managing Employee
MD;		 Jan 1, 2016
Monument Health Rapid City Hospital Inc
Organization · Rapid City, SD
Non-profit 		5% Or Greater Direct Ownership Interest Jul 1, 2016 100%
Monument Health Inc
Organization · Rapid City, SD
Non-profit 		5% Or Greater Indirect Ownership Interest Jul 1, 2016 100%
Michael F Tilles
Individual 		Corporate Officer
President		 Sep 19, 2016
W-2 Managing Employee
President		 Sep 19, 2016

Change-of-ownership history

DateEventCounterparty
Nov 1, 2016 Change of Ownership
This provider was the buyer		 Rapid City Regional Hospital Hospice
CCN 431501 · SD · NPI 1962479600

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20161201001308 SD Part a Provider - Hospice 8729367776 Practice locations: Rapid City, SD

National Provider Directory

Tax ID family
Regional Health Home Plus LLC (11 organizations share this tax ID)
Part of
Regional Health Home Plus LLC

Locations

931 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 644-4240

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X Yes

Addresses

Primary practice location

224 Elk St
Rapid City, SD 57701-7359

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 755-7649

Other names

  • Monument Health Home Plus Hospice Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solution

Other providers in Rapid City, SD

All providers in Rapid City, SD · Inpatient Hospice in South Dakota

Sources for this page

Verify at the official NPI Registry.