NPIMap

Organization Active NPI

Interim Healthcare Hospice of Western Pennsylvania, Inc.

  • Community Based Hospice Care Agency
  • Pittsburgh, PA
National Provider Identifier
1790923019
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
INTERIM HEALTHCARE HOSPICE OF WESTERN PENNSYLVANIA, INC.
Practice address
285 Kappa Dr Ste 270
Pittsburgh, PA 15238-2814
Phone
(412) 371-3726
Fax
(412) 243-4313
NPI assigned
Jan 23, 2009
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Mr. Thomas J Dimarco
Title
Chief Executive Officer
Phone
(614) 436-9404

Specialties & licenses 1

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

Addresses

Primary practice location

285 Kappa Dr Ste 270
Pittsburgh, PA 15238-2814

Mailing address

285 Kappa Dr Ste 270
Pittsburgh, PA 15238-2814
Phone (412) 371-3726

Other identifiers 2

IdentifierTypeStateIssuer
1023802600001MedicaidPA
002151439OtherPAHIGHMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090610000171 PA Part A Provider - Hospice 5092865204 Practice locations: Pittsburgh, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790923019. Details of each certification follow.

Hospice certification: CCN 391718

Legal name
INTERIM HEALTHCARE HOSPICE OF WESTERN PENNSYLVANIA, INC.
Doing business as
INTERIM HEALTHCARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 17, 2009
Last certification
Apr 23, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 19, 2008 in PA
Enrollment address
285 Kappa Dr
Ste 270
Pittsburgh, PA 15238-2814

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Interim Health Care HospiceCCN 391718 · All quality measures
Ownership
For-Profit
Certified
Jul 17, 2009
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare Hospice of Western Pennsylvania Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Stephanie Wiedner Individual W-2 Managing EmployeeAdministrator Mar 21, 2023
Operational/Managerial Control Mar 21, 2023
Nicholas Reiser Individual Corporate OfficerVice President & Coo Apr 19, 2023
Corporate DirectorDirector Apr 19, 2023
Salo Inc Organization, Worthington, OH For-profit 5% Or Greater Direct Ownership Interest Dec 19, 2008 100%
Aimee Castor Individual W-2 Managing EmployeeArea Director of Operations Oct 9, 2023
Operational/Managerial ControlArea Director of Operations Oct 9, 2023
Jason Merkle Individual Corporate OfficerVice President Hospice Operations Mar 11, 2024
W-2 Managing EmployeeVice President Hospice Operat Mar 11, 2024
Christine D Oswald Individual 5% Or Greater Indirect Ownership Interest May 8, 2009 8.5%
Corporate OfficerCfo Dec 19, 2008
Corporate DirectorBoard Member Dec 19, 2008
Richard Michael Kastelic Individual Contracted Managing EmployeeMedical Director Aug 16, 2012
Thomas Joseph Dimarco Individual 5% Or Greater Indirect Ownership Interest Dec 19, 2008 70%
Corporate OfficerPresident & Ceo Dec 19, 2008
Corporate DirectorPresident & Board Member Dec 19, 2008

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 24

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

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 11

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": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1790923019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 KAPPA DR STE 270",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382814",
            "telephone_number": "412-371-3726",
            "fax_number": "412-243-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 KAPPA DR STE 270",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382814",
            "telephone_number": "412-371-3726",
            "fax_number": "412-243-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE HOSPICE OF WESTERN PENNSYLVANIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "DIMARCO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "614-436-9404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023802600001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "002151439",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.