Ennoble Hospice NJ LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ENNOBLE HOSPICE NJ LLC

Practice address

700 Grand Ave Ste 5B
Hackettstown, NJ 07840-1145

Phone

(973) 435-9463

NPI assigned

Dec 21, 2016

Last updated

Dec 22, 2023By 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

Kushabhadra Das

Title

Ceo

Phone

(862) 821-9010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922543388. Details of each certification follow.

• CCN 311585 Hospice · Active · Details

Hospice certification: CCN 311585

Legal name

ENNOBLE HOSPICE NJ LLC

Doing business as

ENNOBLE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 28, 2017

Last certification

Jan 13, 2021

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Incorporated

Apr 20, 2021 in NJ

Enrollment address

700 Grand St
Unit 5B
Hackettstown, NJ 07840-6211

Listed as

Ennoble CareCCN 311585 · All quality measures

Ownership

For-Profit

Certified

Dec 28, 2017

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 4

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.

• Michelle Reisner, MD

  • Internal Medicine Physician
  • Jersey City, NJ
  • NPI 1942267158

  W-2 Managing Employee

  CMS ownership

Change-of-ownership history 2

Affiliated clinicians 61

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

• Jesse Susan Abesh, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Stratford, NJ
  • NPI 1487067674

  Hospice

  Care Compare affiliation
• Naveen Reddy Allam, M.D.

  • Internal Medicine Physician
  • Montclair, NJ
  • NPI 1790051191

  Hospice

  Care Compare affiliation
• Anastasia Alosi, FNP

  • Family Nurse Practitioner
  • Hackensack, NJ
  • NPI 1881352565

  Hospice

  Care Compare affiliation
• John R Amrien, M.D.

  • Family Medicine Physician
  • Salem, NJ
  • NPI 1497757173

  Hospice

  Care Compare affiliation
• Mary Kristelyn Ann Asok, MSN APRN FNP-BC

  • Family Nurse Practitioner
  • New Milford, NJ
  • NPI 1891447280

  Hospice

  Care Compare affiliation
• Rengaswamy Asokan, MD

  • Internal Medicine Physician
  • Newfoundland, NJ
  • NPI 1639196256

  Hospice

  Care Compare affiliation
• Atul Bhasin, MD

  • Internal Medicine Physician
  • Freehold, NJ
  • NPI 1619989639

  Hospice

  Care Compare affiliation
• Robert Tamas Bock Jr., M.D.

  • Legal Medicine
  • Newfoundland, NJ
  • NPI 1245251891

  Hospice

  Care Compare affiliation
• Timothy Brabston, MD

  • Internal Medicine Physician
  • Pompton Lakes, NJ
  • NPI 1184607863

  Hospice

  Care Compare affiliation
• Santhosh Chakilam, M.D.

  • Internal Medicine Physician
  • Parsippany, NJ
  • NPI 1184988628

  Hospice

  Care Compare affiliation
• Joseph Peter Curreri, DO

  • Pulmonary Disease Physician
  • Merchantville, NJ
  • NPI 1609852623

  Hospice

  Care Compare affiliation
• Andrea P Faller, FNBC

  • Family Nurse Practitioner
  • Voorhees, NJ
  • NPI 1396512877

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1922543388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 GRAND AVE STE 5B",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401145",
            "telephone_number": "973-435-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GRAND AVE STE 5B",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401145",
            "telephone_number": "973-435-9463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Haddonfield Berlin Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080433520",
            "country_code": "US",
            "telephone_number": "609-722-8069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENNOBLE HOSPICE NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "DAS",
        "authorized_official_first_name": "KUSHABHADRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "862-821-9010"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Hackettstown, NJ
• Providers in Hackettstown, NJ by specialty
• Community Based Hospice Care Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.