NPIMap

Organization Active NPI

Presbyterian Homes Hospice Inc

  • Community Based Hospice Care Agency
  • Waukesha, WI
National Provider Identifier
1730916248
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRESBYTERIAN HOMES HOSPICE INC
Practice address
222 Park PL
Waukesha, WI 53186-4858
Phone
(651) 746-8200
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Jill Nance
Title
Hospice Administrator
Phone
(651) 631-6406

Specialties & licenses 1

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

Addresses

Primary practice location

222 Park PL
Waukesha, WI 53186-4858

Mailing address

2845 Hamline Ave N
Roseville, MN 55113-7127
Phone (651) 746-8200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250620002314 WI Part A Provider - Hospice 3971674961 Practice locations: Waukesha, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730916248. Details of each certification follow.

Hospice certification: CCN 521628

Legal name
PRESBYTERIAN HOMES HOSPICE INC
Doing business as
OPTAGE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 31, 2025
Last certification
Oct 14, 2025
Organization structure
CorporationNon-profit
Enrollment address
222 Park PL
Waukesha, WI 53186

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Optage HospiceCCN 521628 · All quality measures
Certified
Oct 31, 2025
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
52D2322822Presbyterian Homes Hospice, Dba Optage Hospice222 Park PL, Waukesha, WI 53186Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 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.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Christa K Hoiland Individual W-2 Managing EmployeeMD; Aug 1, 2014
Mike Bingham Individual Corporate DirectorBoard Member Oct 1, 2011
Daniel a Lindh Individual Corporate DirectorBoard Member Jan 1, 1997
PHS Management, LLC Organization, Saint Paul, MN Non-profit, Chain home office Operational/Managerial Control Mar 11, 2011 100%
Jill Nance Individual W-2 Managing EmployeeAd; Oct 18, 2011
Amy Eisenhut Individual W-2 Managing EmployeeClinical Administrator Aug 20, 2024 80%
Mark Meyer Individual Corporate DirectorBoard Member, Cfo Oct 1, 2011

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1730916248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137127",
            "telephone_number": "651-746-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PARK PL",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864858",
            "telephone_number": "651-746-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "HOSPICE ADMINISTRATOR",
        "authorized_official_telephone_number": "651-631-6406"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.