NPIMap

Organization Active NPI

Bridge Hospice Central Coast LLC

  • Community Based Hospice Care Agency
  • Salinas, CA
National Provider Identifier
1710479233
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BRIDGE HOSPICE CENTRAL COAST LLC
Practice address
6 Quail Run Cir Ste 103
Salinas, CA 93907-2345
Phone
(831) 216-5585
NPI assigned
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Jeff Mongonia
Title
Ceo
Phone
(858) 251-4242

Specialties & licenses 1

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

Addresses

Primary practice location

6 Quail Run Cir Ste 103
Salinas, CA 93907-2345

Mailing address

3636 Nobel Dr Ste 450
San Diego, CA 92122-1062

Other names 1

  • Bridge Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323001037 CA Part A Provider - Hospice 3173867983 Practice locations: Salinas, CA

Hospice certification: CCN B21615

Legal name
BRIDGE HOSPICE CENTRAL COAST LLC
Doing business as
BRIDGE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 2, 2021
Last certification
Jul 2, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Mar 20, 2018 in CA
Enrollment address
6 Quail Run Cir
Ste 103
Salinas, CA 93907-2345

Care Compare: Hospice

Medicare Care Compare
Listed as
Bridge HospiceCCN B21615
Ownership
For-Profit
Certified
Jul 2, 2021
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
05D2162741Bridge Hospice Central Coast LLC6 Quail Run Circle, Suite 103, Salinas, CA 93907Certificate of waiverFeb 27, 2027

National Provider Directory

National Provider Directory

Locations

601 E Romie Ln
Ste 4
Salinas, CA 93901
Phone (831) 216-5558

6 Quail Run Cir
Ste 103
Salinas, CA 93907
Phone (831) 216-5585

5090 Shoreham Pl
Ste 209
San Diego, CA 92122
Phone (582) 775-2008

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
Jennifer Robinson Individual Contracted Managing EmployeeAdministrator Designee Dec 1, 2024
Operational/Managerial ControlAdministrator Designee Dec 1, 2024
Bridge Group Holdco LLC Organization, San Diego, CA Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 20, 2018 100%
Vincent Castaldo Individual Corporate OfficerCfo May 29, 2024
Ahp HH&H Holdco LLC Organization, New York, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 31, 2023 82.8%
Jeffrey W Mongonia Individual Corporate OfficerCeo Apr 14, 2023
Jennifer L Prouty Boertje Individual Contracted Managing EmployeeDPCS Designee Dec 1, 2024
Operational/Managerial ControlDPCS Designee Dec 1, 2024
Bridge Group HH Inc Organization, San Diego, CA Created for acquisition, Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 20, 2018 100%
Operational/Managerial Control Mar 20, 2018
Cortland Young Individual Contracted Managing EmployeeAd;DPCS Feb 15, 2024
Operational/Managerial ControlAdministrator & DPCS Feb 15, 2024
Vivek Rudrapatna Individual Contracted Managing EmployeeMD; Jan 16, 2019

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 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1710479233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 NOBEL DR STE 450",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 QUAIL RUN CIR STE 103",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939072345",
            "telephone_number": "831-216-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE HOSPICE CENTRAL COAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "MONGONIA",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-251-4242"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.