The Evangelical Lutheran Good Samaritan Society

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing business as

Good Samaritan Society- Homec Care and Hospice

Practice address

24090 Smiley Rd Ste 200
Nisswa, MN 56468

Phone

(218) 963-9842

NPI assigned

Aug 15, 2006

Last updated

Sep 20, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

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

Authorized official

Name

Eric Vandenhull

Title

Executive VP

Phone

(605) 362-3900

Specialties & licenses 1

Addresses

Other names 1

• Good Samaritan Society- Homec Care and Hospice Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740293083. Details of each certification follow.

• CCN 241581 Hospice · Active · Details

Hospice certification: CCN 241581

Legal name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing business as

GOOD SAMARITAN SOCIETY - HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 26, 2007

Last certification

Jun 8, 2017

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 22, 1922 in ND

Enrollment address

24090 Smiley Rd
Ste 200
Nisswa, MN 56468-2946

Listed as

Good Samaritan Society HospiceCCN 241581 · All quality measures

Ownership

Non-Profit

Certified

Jan 26, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Good Samaritan Home210 organizations share this tax ID, including this one

Part of

Good Samaritan Home

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Home Care

  • Home Health Agency
  • Saint Peter, MN
  • NPI 1497738520
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Maplewood

  • Skilled Nursing Facility
  • Saint Paul, MN
  • NPI 1508856998
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Pine River

  • Skilled Nursing Facility
  • Pine River, MN
  • NPI 1558342972
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Riverside Senior Living Apartments

  • Assisted Living Facility
  • Pine River, MN
  • NPI 1588834238
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Woodland Senior Living Apartments

  • Assisted Living Facility
  • Brainerd, MN
  • NPI 1609294859
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba The Pines

  • Assisted Living Facility
  • Jackson, MN
  • NPI 1629151154
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Birchwood Samaritan House

  • Assisted Living Facility
  • Brainerd, MN
  • NPI 1629176383
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Battle Lake

  • Skilled Nursing Facility
  • Battle Lake, MN
  • NPI 1639153398
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Albert Lea

  • Skilled Nursing Facility
  • Albert Lea, MN
  • NPI 1659352326
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Specialty Care Community

  • Skilled Nursing Facility
  • Robbinsdale, MN
  • NPI 1659361061
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Howard Lake

  • Skilled Nursing Facility
  • Howard Lake, MN
  • NPI 1689655086
  NPD tax ID
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Woodland

  • Skilled Nursing Facility
  • Brainerd, MN
  • NPI 1720078140
  NPD tax ID

Locations

All disclosed owners & managing parties 22

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

Owners & managing parties with NPI records 1

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

• Joseph Moriarty, MD

  • Family Medicine Physician
  • Baxter, MN
  • NPI 1780662007

  Contracted Managing Employee

  CMS ownership

All facility ownership & control disclosures 107

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

Showing 100 of 107 facilities.

Facilities with the same owner 106

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

• Edgebrook Care Center

  • Skilled Nursing Facility
  • Edgerton, MN
  • NPI 1003893447

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Home Care

  • Home Health Agency
  • Robbinsdale, MN
  • NPI 1033191416

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Pleasant View

  • Skilled Nursing Facility
  • Saint James, MN
  • NPI 1043291719

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Home Care of Southwest Minnesota

  • Home Health Agency
  • Windom, MN
  • NPI 1073595484

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Ambassador

  • Skilled Nursing Facility
  • New Hope, MN
  • NPI 1114908878

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Jackson

  • Skilled Nursing Facility
  • Jackson, MN
  • NPI 1134119563

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Stillwater

  • Skilled Nursing Facility
  • Stillwater, MN
  • NPI 1215927611

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Mary Jane Brown

  • Skilled Nursing Facility
  • Luverne, MN
  • NPI 1225013618

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Home Health

  • Home Health Agency
  • Nisswa, MN
  • NPI 1225017320

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Waconia

  • Skilled Nursing Facility
  • Waconia, MN
  • NPI 1235110081

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - The Village

  • Skilled Nursing Facility
  • Mountain Lake, MN
  • NPI 1265423990

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Inver Grove Heights

  • Skilled Nursing Facility
  • Inver Grove, MN
  • NPI 1366423147

  The Evangelical Lutheran Good Samaritan Society

  CMS ownership

Affiliated clinicians 2

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

• Dinesh Bande, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1083866339

  Hospice

  Care Compare affiliation
• Julie Kay Olson, M.D,

  • Internal Medicine Physician
  • Brainerd, MN
  • NPI 1740264530

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1740293083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24090 SMILEY RD STE 200",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564682946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24090 SMILEY RD STE 200",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "56468",
            "telephone_number": "218-963-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "VANDENHULL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "605-362-3900"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society- Homec Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynn Marie Steidler-Thompson
• Valerie Stenger, COTA/L
• Aron Michael Stumvoll, DC
• Lisa Marie Swenson, RDCS
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Home Health)
• Mary Katherine Verkennes, M.A. L.P.
• Luke E. Waln, DDS
• Wellnessone of Nisswa

• Community Based Hospice Care Agency in Nisswa, MN
• Providers in Nisswa, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.