NPIMap

Organization Active NPI

Mt Rose Health Center Palliative Care and Hospice Inc

  • Inpatient Hospice
  • Trinidad, CO
National Provider Identifier
1982052452
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
License
38779 Issued in CO
Legal business name
MT ROSE HEALTH CENTER PALLIATIVE CARE AND HOSPICE INC
Practice address
409 Benedicta Ave
Suite a
Trinidad, CO 81082-2004
Phone
(719) 846-8478
Fax
(719) 846-2941
NPI assigned
May 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Authorized official

Name
Ms. Valerie J Borsa, MDNPI 1265490676
Title
Medical Director
Phone
(719) 680-2677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X 38779 CO Primary

Addresses

Primary practice location

409 Benedicta Ave
Suite a
Trinidad, CO 81082-2004

Mailing address

409 Benedicta Ave
Suite a
Trinidad, CO 81082-2004
Phone (719) 846-8478

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180417000108 CO Part A Provider - Hospice 3870856305 Practice locations: Trinidad, CO

Hospice certification: CCN 061604

Legal name
MT ROSE HEALTH CENTER PALLIATIVE CARE AND HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 27, 2018
Last certification
Jun 27, 2018
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Apr 7, 2016 in CO
Enrollment address
1114 E Main St
Trinidad, CO 81082-2034

Care Compare: Hospice

Medicare Care Compare
Listed as
Mt Rose Health Center Palliative Care and Hospice Inc.CCN 061604
Ownership
Non-Profit
Certified
Jun 27, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Valerie Jean Borsa Individual 5% Or Greater Direct Ownership Interest Apr 7, 2016 100%
Corporate OfficerPresident, Owner, Board Member Apr 7, 2016
Corporate DirectorPresident, Owner, Board Member Apr 7, 2016
W-2 Managing EmployeePresident, Owner, Board Member Apr 7, 2016
Margaret Hamlin Individual Corporate OfficerTreasurer, Board Member Apr 7, 2016
Corporate DirectorTreasurer, Board Member Apr 7, 2016
Katherine M Bueno Individual Corporate OfficerVice President, Board Member Apr 7, 2016
Corporate DirectorVice President, Board Member Apr 7, 2016

Owners & managing parties with NPI records 1

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

  • Valerie Jean Borsa, M.D.
    • Internal Medicine Physician
    • Trinidad, CO
    • NPI 1265490676

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1982052452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 BENEDICTA AVE",
            "address_2": "SUITE A",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822004",
            "telephone_number": "719-846-8478",
            "fax_number": "719-846-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BENEDICTA AVE",
            "address_2": "SUITE A",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822004",
            "telephone_number": "719-846-8478",
            "fax_number": "719-846-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT ROSE HEALTH CENTER PALLIATIVE CARE AND HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "BORSA",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "719-680-2677",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "CO",
            "license": "38779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinidad, CO

Sources for this page

Verify at the official NPI Registry.