NPIMap

Organization Active NPI

Ashlar Home Health and Hospice Services LLC

  • Home Health Agency
  • Elizabethtown, PA
National Provider Identifier
1992257042
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ASHLAR HOME HEALTH AND HOSPICE SERVICES LLC
Practice address
1 Masonic Dr
Elizabethtown, PA 17022-2199
Phone
(717) 367-1121
Fax
(717) 367-6768
NPI assigned
Oct 25, 2016
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Justin Wolgemuth
Title
Senior VP of Operations
Phone
(717) 367-1121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1 Masonic Dr
Elizabethtown, PA 17022-2199

Mailing address

1 Masonic Dr
Elizabethtown, PA 17022-2199
Phone (717) 367-1121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170119001837 PA Part A Provider - Home Health Agency 2264714666 Practice locations: Elizabethtown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992257042. Details of each certification follow.

Home health agency certification: CCN 398272

Legal name
ASHLAR HOME HEALTH AND HOSPICE SERVICES LLC
Doing business as
MASONIC VILLAGE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 25, 2017
Last certification
May 25, 2017
Ownership / control type
Non-Profit
Organization structure
LLCNon-profit
Incorporated
Oct 17, 2016 in PA
Enrollment address
98 Masonic Dr
Ste 101
Elizabethtown, PA 17022-2574

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Masonic Village Home HealthCCN 398272 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
May 25, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Ashlar Home Health and Hospice Services LLC4 organizations share this tax ID, including this one
Part of
Masonic Villages of PA

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Patrick J Sampsell Individual Corporate OfficerSecretary Dec 29, 2021
Brenda Spence Individual W-2 Managing EmployeeDirector of Resident Accounts Oct 17, 2016
William Kingsbury Individual Corporate OfficerBoard of Directors/Ceo Jan 1, 2020
Adrienne Staudenmayer Individual Corporate OfficerCoo Dec 29, 2021
Justin E Wolgemuth Individual Corporate OfficerSenior VP Jan 1, 2020
John F Pyfer Individual Corporate DirectorBoard of Directors Jan 1, 2020
Pamela Formica Individual Corporate OfficerTreasurer/Cfo Jan 1, 2020
John J Mast Individual Contracted Managing EmployeeMD; Jun 9, 2021
Debra a Brockman Individual Corporate DirectorBoard Member Oct 17, 2016
Masonic Villages of the Grand Lodge of Pennsylvania Organization, Elizabethtown, PA Non-profit 5% Or Greater Direct Ownership Interest Oct 17, 2016 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1992257042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MASONIC DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222199",
            "telephone_number": "717-367-1121",
            "fax_number": "717-367-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MASONIC DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222199",
            "telephone_number": "717-367-1121",
            "fax_number": "717-367-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAR HOME HEALTH AND HOSPICE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA",
        "enumeration_date": "2016-10-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "WOLGEMUTH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "SENIOR VP OF OPERATIONS",
        "authorized_official_telephone_number": "717-367-1121"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

Verify at the official NPI Registry.