McLean Affiliates, Inc.
Organization Active NPI Community Based Hospice Care Agency · Simsbury, CT
NPI 1891813655 · NPPES record last updated Jul 10, 2014
Key facts
- NPI
- 1891813655
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- C8518N (CT)
- Legal business name
- MCLEAN AFFILIATES, INC.
- Practice address
- 75 Great Pond Rd
Simsbury, CT 06070-1980 - Phone
- (860) 658-3950
- Fax
- (860) 408-1319
- NPI assigned
- Mar 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cheryl Kozieradzki
- Title
- Manager
- Phone
- (860) 658-3950
Owners & managing parties with NPI records 1
-
Kevin Matthew Baran, M.D., M.P.H.
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 2
Affiliated clinicians 13
-
Joseph T Anquillare Sr., M.D.
-
Kevin Matthew Baran, M.D., M.P.H.
-
Karina M Berg, MD
-
Victoria Walker Costello, M.D.
-
Jaclyn Susan Jaeger, D.O.
-
Anna Meola, DO
-
Gary Miller, MD
-
Gagandeep Singh, MD
-
Hollie Suzanne Smith, APRN
-
Judith Chinenye Ukabam, M.D.
Medicare Care Compare: Hospice
- Listed as
- McLean Home Care and Hospice
- Ownership
- Non-Profit
- Certified
- Jan 5, 1995
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Hospice certification: CCN 071524
- Legal name
- MCLEAN AFFILIATES, INC.
- Doing business as
- MCLEAN HOME CARE & HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 5, 1995
- Last certification
- Jan 27, 2022
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 1, 2009 in CT
- Enrollment address
- 75 Great Pond Rd
McLean Home Care & Hospice
Simsbury, CT 06070-1980
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Linda Schofield |
Corporate Director | Jan 1, 2023 | |
| Jared Grise |
Corporate Director | Jan 1, 2023 | |
| Kathleen Alsgard |
Corporate Director | Jan 1, 2023 | |
| Denis Horrigan |
Corporate Director | Jan 1, 2023 | |
| Margaret Coburn |
Corporate Officer |
Jun 20, 2016 | |
| W-2 Managing Employee |
Jun 20, 2016 | ||
| Kevin M Baran |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee |
Jan 1, 2012 | ||
| Lisa Clark |
Corporate Officer |
Jul 1, 2022 | |
| W-2 Managing Employee | Jul 1, 2022 | ||
| Operational/Managerial Control |
Jul 1, 2022 | ||
| Philip J Schulz |
Corporate Director | Jan 1, 2023 | |
| Michael Paine-Chairman |
Corporate Director |
Dec 19, 2016 | |
| James Cox-Chapman |
Corporate Director | Jan 1, 2023 | |
| Mark Wetzel |
Corporate Director | Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091208000005 | CT | Part a Provider - Hospice | 6800950015 | Practice locations: Simsbury, CT |
National Provider Directory
- Tax ID family
- Ability Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | C8518N | CT | Yes |
Addresses
Primary practice location
75 Great Pond Rd
Simsbury, CT 06070-1980
Mailing address
75 Great Pond Rd
Simsbury, CT 06070-1980
Phone (860) 658-3950
Other names
- Mc Lean Home Care & Hospice
Other providers in Simsbury, CT
- Alexandra Morley McKenna
- Paul Joseph McKenna Jr.
- McLean Affiliates, Inc.
- McLean Affiliates, Inc.
- McLean Affiliates, Inc.
- McLean Fund
- McLean Fund
- McLean Health Center
- Billie D. McNealey
- Pamela Mary Mears
All providers in Simsbury, CT · Community Based Hospice Care Agency in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.