Physiocare Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PHYSIOCARE HOSPICE LLC

Practice address

1440 Innovation PL
West Lafayette, IN 47906-1000

Phone

(765) 250-3827

Fax

(765) 250-3842

NPI assigned

Jul 7, 2011

Last updated

May 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert A Radics

Title

Ceo

Phone

(404) 787-1570

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760779078. Details of each certification follow.

• CCN 151615 Hospice · Active · Details

Hospice certification: CCN 151615

Legal name

PHYSIOCARE HOSPICE LLC

Doing business as

SELECT HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 1, 2015

Last certification

Jun 1, 2015

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Incorporated

May 11, 2011 in IN

Enrollment address

1440 Innovation PL
West Lafayette, IN 47906-1000

Listed as

Select HospiceCCN 151615 · All quality measures

Ownership

For-Profit

Certified

Jun 1, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 13

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.

• Victor D Bentinganan Jr., DO

  • Family Medicine Physician
  • Otterbein, IN
  • NPI 1306814538

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 7

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

• Physiocare Home Healthcare LLC

  • Home Health Agency
  • West Lafayette, IN
  • NPI 1033445895

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Markets Program, LP, TMM Holdin

  CMS ownership
• Select Home Health Services, LLC

  • Home Health Agency
  • Carmel, IN
  • NPI 1689979965

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Mar

  CMS ownership
• Select Hospice, LLC

  • Community Based Hospice Care Agency
  • Carmel, IN
  • NPI 1023709847

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Mar

  CMS ownership
• Hearts for Hospice, LLC

  dba Valeo Hospice

  • Community Based Hospice Care Agency
  • Orem, UT
  • NPI 1619968781

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP

  CMS ownership
• Hearts for Hospice, LLC

  dba Valeo Home Health

  • Home Health Agency
  • Murray, UT
  • NPI 1922006493

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP

  CMS ownership
• Hearts for Hospice, LLC

  dba Valeo Hospice

  • Community Based Hospice Care Agency
  • Layton, UT
  • NPI 1942290960

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP

  CMS ownership
• Valeo Hospice LLC

  dba Valeo Home Health and Hospice

  • Community Based Hospice Care Agency
  • Murray, UT
  • NPI 1780026617

  East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Lorelei Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP

  CMS ownership

Affiliated clinicians 2

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

• Victor D Bentinganan Jr., DO

  • Family Medicine Physician
  • Otterbein, IN
  • NPI 1306814538

  Hospice

  Care Compare affiliation
• William Y Li, MD

  • Family Medicine Physician
  • Lafayette, IN
  • NPI 1639148349

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1760779078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 INNOVATION PL",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061000",
            "telephone_number": "765-250-3827",
            "fax_number": "765-250-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 INNOVATION PL",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061000",
            "telephone_number": "765-250-3827",
            "fax_number": "765-250-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOCARE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "RADICS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-787-1570"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Perry, FNP
• Haylee Peters
• Jack David Peters
• Phi Health, LLC (PHI Air Medical)
• Physiocare Home Healthcare LLC
• Lucy Helena Pickett, RN
• Sarah Pierce, PHARMD
• Tristin Pierson
• Katherine Pimmler
• Winona Benita Pitts, NP

• Community Based Hospice Care Agency in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Community Based Hospice Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.