NPIMap

Organization Active NPI

Keystone Hospice

  • Community Based Hospice Care Agency
  • Wyndmoor, PA
National Provider Identifier
1992780670
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
159399 Issued in PA
Legal business name
KEYSTONE HOSPICE
Practice address
8765 Stenton Ave
Wyndmoor, PA 19038-8317
Phone
(215) 836-2440
Fax
(215) 836-3470
NPI assigned
Dec 14, 2005
Last updated
Oct 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Ms. Gail Inderwies, RN,BSN,MBA
Title
President Executive Director
Phone
(215) 836-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 159399 PA Primary

Addresses

Primary practice location

8765 Stenton Ave
Wyndmoor, PA 19038-8317

Mailing address

8765 Stenton Ave
Wyndmoor, PA 19038-8317
Phone (215) 836-2440

Other identifiers 10

IdentifierTypeStateIssuer
391593OtherPATRICARE
561447OtherPAAETNA
159399MedicaidPA
X000363701OtherPAAMERICHOICE
0001985000OtherPAINDEPENDENCE BLUE CROSS
0001985000OtherPAKEYSTONE HEALTH PLAN EAST
0001985000OtherPAFEDERAL BLUE CROSS
14622OtherPAHEALTH PARTNERS
0001985000OtherPAPERSONAL CHOICE
1064424OtherPAKEYSTONE MERCY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050621001116 PA Part A Provider - Hospice 3274578240 Practice locations: Wyndmoor, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992780670. Details of each certification follow.

Hospice certification: CCN 391593

Legal name
KEYSTONE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 10, 1995
Last certification
Dec 23, 2020
Ownership / control type
Non-Profit - Private
Organization structure
OtherNon-profit
Incorporated
May 24, 1994 in PA
Enrollment address
8765 Stenton Ave
Wyndmoor, PA 19038-8317

Other NPIs with the same Medicare PAC ID 1

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

  • Keystone Hospice

    dba KeystoneCare Palliative Care Program

    • Internal Medicine Physician
    • Wyndmoor, PA
    • NPI 1912285198

    3274578240

    Same PAC ID

Care Compare: Hospice

Medicare Care Compare
Listed as
Keystone HospiceCCN 391593 · All quality measures
Ownership
Non-Profit
Certified
Feb 10, 1995
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Keystone Hospice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

5401 Old York Rd
Ste 300
Philadelphia, PA 19141
Phone (215) 456-6950

8815 Germantown Ave
#12
Philadelphia, PA 19118
Phone (215) 240-6635

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Peter Amuso Individual Corporate DirectorPresident Feb 13, 2008
Eric Rolin Individual Corporate DirectorTreasurer Dec 12, 2012
June M Fry Individual Corporate Director Mar 1, 2019
Gail a Inderwies Individual Corporate OfficerPresident, Executive Director May 24, 1994
W-2 Managing Employee Jan 24, 1995
Connie M. Bolig Individual Corporate DirectorSecretary Jul 11, 2005

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

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

Affiliated clinicians 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1992780670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 STENTON AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190388317",
            "telephone_number": "215-836-2440",
            "fax_number": "215-836-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 STENTON AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190388317",
            "telephone_number": "215-836-2440",
            "fax_number": "215-836-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "INDERWIES",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "PRESIDENT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-836-2440",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN,BSN,MBA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PA",
            "license": "159399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "391593",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "561447",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159399",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "X000363701",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0001985000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0001985000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE CROSS",
            "identifier": "0001985000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "14622",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "0001985000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1064424",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyndmoor, PA

Sources for this page

Verify at the official NPI Registry.