Compassus Aah of Michigan IV, LLC
Organization Active NPI Community Based Hospice Care Agency · Grand Blanc, MI
NPI 1962019141 · NPPES record last updated Sep 30, 2020
Key facts
- NPI
- 1962019141
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- COMPASSUS AAH OF MICHIGAN IV, LLC
- Practice address
- 5445 Ali Dr Dept 600
Grand Blanc, MI 48439-5195 - Phone
- (810) 344-8396
- Fax
- (844) 552-6192
- NPI assigned
- Sep 30, 2020
- Organization subpart
- No
Authorized official
- Name
- Russell Adkins
- Title
- SVP General Counsel
- Phone
- (615) 309-5668
Owners & managing parties with NPI records 1
-
Najab M. Mirza, D.O.
Facilities with the same owner 162
Affiliated clinicians 15
-
Lina Ataya, MD
-
Robert Kenneth Brummeler, M.D.
-
Harjeet Singh Jhajj, D.O.
-
Najab M. Mirza, D.O.
-
Drew Joseph Packey, D.O.
-
Jay Patel, MD
-
Bernardo A Rojas Jr., M.D.
-
Gary Sheldon Salem, D.O.
-
Michael Samluk, D.O.
-
Heather Dawn Webb, D.O.
-
Imtiaz Ahmed, M.D.
Medicare Care Compare: Hospice
- Listed as
- Compassus - Grand Blanc
- Ownership
- Non-Profit
- Certified
- Mar 18, 1985
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0716892 | Compassus Aah of Michigan IV LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospice certification: CCN 231509
- Legal name
- COMPASSUS AAH OF MICHIGAN IV LLC
- Doing business as
- COMPASSUS - GRAND BLANC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 18, 1985
- Last certification
- May 5, 2016
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 3, 2020 in DE
- Enrollment address
- 5445 Ali Dr
Dept 600
Grand Blanc, MI 48439-5195
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Compassus Parent, Inc. |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 100% |
| Billy Andrew Pate |
Corporate Officer |
Jul 1, 2025 | |
| John Cullen |
Corporate Officer |
Jul 1, 2025 | |
| FC Compassus LLC |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 100% |
| Russell G Adkins |
Corporate Officer |
Oct 1, 2020 | |
| Operational/Managerial Control |
Oct 1, 2020 | ||
| Towerbrook Investors V 892 LP |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 14.23% |
| Compassus Aah Holdings LLC |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 100% |
| Ascension Towerbrook Healthcare Opportunities LP |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 47.66% |
| Compassus Holdings LP |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 100% |
| Najab Mohammed Mirza |
Contracted Managing Employee |
Mar 1, 2021 | |
| Laura a Templeton |
Corporate Officer |
Apr 12, 2023 | |
| Operational/Managerial Control |
Apr 12, 2023 | ||
| Jeremy R Bolling |
Corporate Officer |
Jan 3, 2022 | |
| Ti V Compassus Investment Aggregator, L.P. |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 49.84% |
| Compassus Intermediate Inc |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 100% |
| Towerbrook Investors V (Onshore) LP |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 29.96% |
| Ascension Capital LLC |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 47.63% |
| Compassus Aah Holdings of Michigan LLC |
5% Or Greater Direct Ownership Interest | Oct 1, 2020 | 100% |
| Ascension Health Alliance |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 47.63% |
| Michael Asselta |
Corporate Officer |
May 2, 2024 | |
| Ti V ASC Compassus Investment Aggregator LP |
5% Or Greater Indirect Ownership Interest | Oct 1, 2020 | 97.5% |
| Kimberly Weaver |
W-2 Managing Employee |
Jul 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201109000777 | MI | Part a Provider - Hospice | 6507276268 | Practice locations: Grand Blanc, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
5445 Ali Dr Dept 600
Grand Blanc, MI 48439-5195
Mailing address
10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (417) 841-4834
Other names
- Compassus - Grand Blanc
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2020. 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.