Bristol Hospice - State College, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRISTOL HOSPICE - STATE COLLEGE, LLC

Practice address

170 Rolling Ridge Dr
State College, PA 16801-7674

Phone

(814) 201-7300

Fax

(814) 737-0993

NPI assigned

Jan 26, 2024

Last updated

Sep 3, 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

Alex Mauricio

Title

President/Ceo

Phone

(801) 325-0175

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831951706. Details of each certification follow.

• CCN 731520 Hospice · Active · Details

Hospice certification: CCN 731520

Legal name

BRISTOL HOSPICE - STATE COLLEGE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 28, 2025

Last certification

Mar 19, 2025

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Enrollment address

170 Rolling Ridge Dr
State College, PA 16801-7674

Listed as

Bristol Hospice - State College, LLCCCN 731520 · All quality measures

Certified

Mar 28, 2025

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 15

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.

• Gregory Alexander Skochko, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1588831655

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 52

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

• Bristol Hospice - Blue Bell, LLC

  • Community Based Hospice Care Agency
  • Plymouth Meeting, PA
  • NPI 1356118467

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Bangor, LLC

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1336916469

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Bend, L.L.C.

  • Community Based Hospice Care Agency
  • Bend, OR
  • NPI 1356916845

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - California, LLC

  • Community Based Hospice Care Agency
  • Merced, CA
  • NPI 1487603452

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Charleston, LLC

  • Community Based Hospice Care Agency
  • North Charleston, SC
  • NPI 1326866963

  Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Chicago, L.L.C.

  • Community Based Hospice Care Agency
  • Des Plaines, IL
  • NPI 1104548478

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Eugene, LLC

  • Community Based Hospice Care Agency
  • Springfield, OR
  • NPI 1568962033

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Georgia LLC

  • Community Based Hospice Care Agency
  • Atlanta, GA
  • NPI 1558663872

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Green Bay, L.L.C.

  • Community Based Hospice Care Agency
  • Green Bay, WI
  • NPI 1356928154

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Hawaii, LLC

  dba Bristol Healthcare Services

  • Community Based Hospice Care Agency
  • Honolulu, HI
  • NPI 1811045594

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Inland Empire, LLC

  dba Bristol Hospice - Inland Empire

  • Community Based Hospice Care Agency
  • Riverside, CA
  • NPI 1043683170

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Inland Valley, L.L.C.

  dba All Saints Hospice, Inc.

  • Community Based Hospice Care Agency
  • Ontario, CA
  • NPI 1013318112

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership

Affiliated clinicians 5

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

• Janelle Brumbaugh

  • Family Medicine Physician
  • Hollidaysburg, PA
  • NPI 1831175066

  Hospice

  Care Compare affiliation
• Margaret Mary Hallahan, D.O.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Huntingdon, PA
  • NPI 1972818540
  Care Compare affiliation
• Doriann Lee Lavery, MD

  • Family Medicine Physician
  • Philipsburg, PA
  • NPI 1356598387

  Hospice

  Care Compare affiliation
• Jeffrey W. Pro, M.D.

  • Internal Medicine Physician
  • State College, PA
  • NPI 1114980208

  Hospice

  Care Compare affiliation
• Hiten Patel, M.D.

  • Internal Medicine Physician
  • Toms River, NJ
  • NPI 1902284680

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1831951706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-325-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ROLLING RIDGE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017674",
            "telephone_number": "814-201-7300",
            "fax_number": "814-737-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPICE - STATE COLLEGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "801-325-0175"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alwyn Brittain, MASTER OF ARTS
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• Jennifer Leigh Brooks
• Danessa Rae Brown, DPT, PT

• Community Based Hospice Care Agency in State College, PA
• Providers in State College, PA by specialty
• Community Based Hospice Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.