NPIMap

Organization Active NPI

McLean Affiliates, Inc.

  • Community Based Hospice Care Agency
  • Simsbury, CT
National Provider Identifier
1891813655
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
C8518N Issued in 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
Last updated
Jul 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Authorized official

Name
Mrs. Cheryl Kozieradzki
Title
Manager
Phone
(860) 658-3950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X C8518N CT Primary

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 1

  • Mc Lean Home Care & Hospice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091208000005 CT Part A Provider - Hospice 6800950015 Practice locations: Simsbury, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891813655. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Feb 1, 2009 in CT
Enrollment address
75 Great Pond Rd
McLean Home Care & Hospice
Simsbury, CT 06070-1980

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
McLean Home Care and HospiceCCN 071524 · All quality measures
Ownership
Non-Profit
Certified
Jan 5, 1995
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ability Network3 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 11

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

NameRoleSinceShare
Linda Schofield Individual Corporate Director Jan 1, 2023
Jared Grise Individual Corporate Director Jan 1, 2023
Kathleen Alsgard Individual Corporate Director Jan 1, 2023
Denis Horrigan Individual Corporate Director Jan 1, 2023
Margaret Coburn Individual Corporate OfficerAdministrator Jun 20, 2016
W-2 Managing EmployeeAdministrator Jun 20, 2016
Kevin M Baran Individual Corporate OfficerMedical Director Jan 1, 2012
W-2 Managing EmployeeMedical Director Jan 1, 2012
Lisa Clark Individual Corporate OfficerPresident Jul 1, 2022
W-2 Managing Employee Jul 1, 2022
Operational/Managerial ControlPresident Jul 1, 2022
Philip J Schulz Individual Corporate Director Jan 1, 2023
Michael Paine-Chairman Individual Corporate DirectorChair Person, Board of Directors Dec 19, 2016
James Cox-Chapman Individual Corporate Director Jan 1, 2023
Mark Wetzel Individual Corporate Director Jan 1, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1891813655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 GREAT POND RD",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701980",
            "telephone_number": "860-658-3950",
            "fax_number": "860-408-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 GREAT POND RD",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701980",
            "telephone_number": "860-658-3950",
            "fax_number": "860-408-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN AFFILIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "KOZIERADZKI",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-658-3950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CT",
            "license": "C8518N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mc Lean Home Care & Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Simsbury, CT

Sources for this page

Verify at the official NPI Registry.