NPIMap

Organization Active NPI

Masonicare Home Health and Hospice, Inc.

  • Home Health Agency
  • Wallingford, CT
National Provider Identifier
1710976220
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
C841181 Issued in CT
Legal business name
MASONICARE HOME HEALTH AND HOSPICE, INC.
Practice address
110 S Turnpike Rd
Wallingford, CT 06492-4342
Phone
(203) 679-5200
NPI assigned
Oct 18, 2005
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Jon-Paul Venoit
Title
President Ceo
Phone
(203) 679-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X C841181 CT Primary
Home Health Aide 374U00000X C841181 CT

Addresses

Primary practice location

110 S Turnpike Rd
Wallingford, CT 06492-4342

Mailing address

PO Box 70
Wallingford, CT 06492-7001

Other identifiers 4

IdentifierTypeStateIssuer
682OtherCTBCBS
004129731OtherCTSELF DIRECTED
9219590OtherCTUNEMPLOYMENT
004054789MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040921000635 CT Part A Provider - Home Health Agency 2769450493 Practice locations: Glastonbury, CT; Norwich, CT; Wallingford, CT
O20060117000909 CT Part A Provider - Hospice 2769450493 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Hartford, CT; Norwich, CT; Wallingford, CT

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1710976220. Details of each certification follow.

Home health agency certification: CCN 077159

Legal name
MASONICARE HOME HEALTH AND HOSPICE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 13, 1984
Last certification
Jul 21, 2021
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 20, 1999 in CT
Enrollment address
97 Barnes Rd
Ste 4
Wallingford, CT 06492-1885
HHA Branch

Hospice certification: CCN 071516B

Legal name
MASONICARE HOME HEALTH AND HOSPICE, INC.
Organization structure
CorporationNon-profit
Incorporated
Jan 20, 1999 in CT
Enrollment address
97 Barnes Rd
Ste 4
Wallingford, CT 06492-1885

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Masonicare Home Health & Hospice, IncCCN 077159 · All quality measures
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
Apr 13, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Member organizations 2

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

Locations

110 S Turnpike Rd
Wallingford, CT 06492
Phone (800) 528-6664

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Steven Beaulieu Individual Corporate DirectorCfo & Assistant Treasurer Nov 1, 2020
W-2 Managing EmployeeCfo & Assistant Treasurer Oct 12, 2020
Corporate DirectorCfo & Assistant Treasurer Oct 12, 2020
Christopher Earle Individual Corporate OfficerChair Apr 8, 2024
Corporate OfficerVice Chair Jan 5, 2022
Jon-Paul Venoit Individual Corporate DirectorPresident & Ceo Assistant Secretary Oct 1, 2016
W-2 Managing EmployeePresident & Ceo Assistant Secretary Oct 1, 2016
Corporate DirectorCoo and Assistant Secretary Oct 1, 2015
W-2 Managing EmployeeCoo and Assistant Secretary Oct 1, 2015
Newton Buckner Individual Corporate OfficerTreasurer Nov 6, 2019
Laura G St. John Individual Corporate DirectorExecutive Director Jan 29, 2024
W-2 Managing EmployeeExecutive Director Jan 29, 2024
Bonnie McWain Individual Corporate OfficerSecretary Apr 8, 2024
Bruce Bellmore Individual Corporate OfficerVice Chair Apr 8, 2024
Ann M Olson Individual Corporate DirectorExecutive Director Dec 7, 2020
W-2 Managing EmployeeExecutive Director Dec 7, 2020
Robert F Polito Individual Corporate OfficerChair Jan 5, 2022
Patrick Birney Individual Corporate OfficerSecretary Jan 5, 2022

Practitioners & affiliated clinicians

Affiliated clinicians 77

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

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1710976220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064927001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S TURNPIKE RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924342",
            "telephone_number": "203-679-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONICARE HOME HEALTH AND HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "VENOIT",
        "authorized_official_first_name": "JON-PAUL",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "203-679-6000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "C841181",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CT",
            "license": "C841181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "682",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF DIRECTED",
            "identifier": "004129731",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNEMPLOYMENT",
            "identifier": "9219590",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004054789",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.