BRISTOL HOSPICE - DALLAS
NPI 1952505240
Hospice Care, Community Based in Addison, TX

NPI Status: Active since June 12, 2007

Contact Information

16901 DALLAS PKWY STE 114
ADDISON, TX
ZIP 75001
Phone: (214) 221-9216
Fax: (214) 221-9262

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  • Organization
  • Hospice Care, Community Based
  • Accepts Insurance
  • CLIA Number: 45D1073369
  • CLIA Cert. Type: Hospice
  • CLIA Exp. Date: 09-06-2025

About BRISTOL HOSPICE - DALLAS

This page provides the complete NPI Profile along with additional information for Bristol Hospice - Dallas, a provider established in Addison, Texas operating as a Hospice Care, Community Based. The healthcare provider is registered in the NPI registry with number 1952505240 assigned on June 2007. The practitioner's primary taxonomy code is 251G00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Bristol Hospice - Dallas. The authorized official of this NPI record is Alex E Mauricio (President)

NPI
1952505240
Provider Legal Name
KMS HEALTH INC
Other Organization Name
BRISTOL HOSPICE - DALLAS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
16901 DALLAS PKWY STE 114 ADDISON, TX 75001
Location Phone
(214) 221-9216
Location Fax
(214) 221-9262
Mailing Address
206 N 2100 W STE 202 SALT LAKE CITY, UT 84116
Mailing Phone
(801) 325-0175
Mailing Fax
(214) 221-9262
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-12-2007
Last Update Date
09-07-2023
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According to the Hospice Quality Reporting Program (HQRP) data this facility is for-profit and was certified on 05-06-2009 This facility was recently evaluated on the following quality measures: average daily census, hospice served at least 1 patient with both medicare and medicaid coverage during one year, hospice served at least 1 patient enrolled in medicare advantage during one year, care provided in assisted living facility and care provided in home, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospice Care, Community Based

Taxonomy Code
251G00000X
Type
Agencies

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 12 - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ALEX E MAURICIO

Authorized Official Title
PRESIDENT
Authorized Official Phone
(801) 325-0175

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1032070MEDICAID (05)TX 

Hospice Care Information

The Centers for Medicare and Medicaid Services Hospice Quality Reporting Program (HQRP) data provides information on the quality of care that hospice facilities are providing to their patients. The quality reporting data gives families and patients the information they need to decide which hospice is right for them.

CMS Certification Number (CCN)671622
Ownership TypeFor-Profit
Medicare Certification Date05-06-2009
Quality Measure Measure Score
Average Daily Census
Number of patients cared for by a hospice on average each day
80.0
Hospice served at least 1 patient with both Medicare and Medicaid coverage during one year
1= Hospice served at least 1 patient with both Medicaid and Medicare coverage OR 0 = Hospice did not serve any patients with both Medicaid and Medicare coverage
Yes
Hospice served at least 1 patient enrolled in Medicare Advantage during one year
1 = Hospice served at least one patient enrolled in Medicare Advantage OR 0 = Hospice did not serve any patients enrolled in Medicare Advantage
Yes
Care Provided in Assisted Living Facility
Percentage of days patients received care in an assisted living facility
7
Care Provided in Home
Percentage of days patients received care in home
47
Care Provided in Inpatient Hospice Facility
Percentage of days patients received care in an inpatient hospice
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Care Provided in Inpatient Hospital Facility
Percentage of days patients received care in an inpatient hospital
1
Care Provided in Nursing Facility
Percentage of days patients received care in a nursing facility
37
Care Provided in All other locations
Percentage of days patients received care in other locations
6
Care Provided in Skilled Nursing Facility
Percentage of days patients received care in a skilled nursing facility
2
Hospice and Palliative Care Treatment Preferences
Facility observed rate
98.6
Beliefs & Values Addressed (if desired by the patient)
Facility observed rate
100.0
Hospice and Palliative Care Pain Screening
Facility observed rate
98.6
Hospice and Palliative Care Pain Assessment
Facility observed rate
100.0
Hospice and Palliative Care Dyspnea Screening
Facility observed rate
98.6
Hospice and Palliative Care Dyspnea Treatment
Facility observed rate
94.8
Patient Treated with an Opioid Who Are Given a Bowel Regimen
Facility observed rate
97.3
Hospice and Palliative Care Composite Process Measure
Facility observed rate
94.7
Hospice Visits in the Last Days of Life
238
Hospice Visits in the Last Days of Life
Facility observed rate
53.8
Hospice Care Index Overall Score
Facility observed rate
9.0
CHC/GIP provided (% days)
57,579
CHC/GIP provided (% days)
Facility observed rate
0.0
CHC/GIP provided (% days)
51
Gaps in nursing visits (% elections)
302
Gaps in nursing visits (% elections)
Facility observed rate
74.8
Gaps in nursing visits (% elections)
79
Early live discharges (% live discharges)
137
Early live discharges (% live discharges)
Facility observed rate
8.0
Early live discharges (% live discharges)
65
Late live discharges (% live discharges)
137
Late live discharges (% live discharges)
Facility observed rate
47.4
Late live discharges (% live discharges)
71
Burdensome transitions, Type 1(% live discharges)
137
Burdensome transitions, Type 1 (% live discharges)
Facility observed rate
15.3
Burdensome transitions, Type 1 (% live discharges)
85
Burdensome transitions, Type 2(% live discharges)
137
Burdensome transitions, Type 2 (% live discharges)
Facility observed rate
6.6
Burdensome transitions, Type 2 (% live discharges)
94
Per-beneficiary spending (U.S. dollars $)
469
Per-beneficiary spending (U.S. dollars $)
Facility observed rate
20,793
Per-beneficiary spending (U.S. dollars $)
72
Nurse care minutes per routine home care days (minutes)
57,347
Nurse care minutes per routine home care days (minutes)
Facility observed rate
10.6
Nurse care minutes per routine home care days (minutes)
31
Skilled nursing minutes on weekends (% minutes)
607,140
Skilled nursing minutes on weekends (% minutes)
Facility observed rate
8.0
Skilled nursing minutes on weekends (% minutes)
50
Visits near death (% decedents)
293
Visits near death (% decedents)
Facility observed rate
87.4
Visits near death (% decedents)
26
Percent of Patients with Cancer
Percentage of patients at hospice who had Cancer as their primary diagnosis
15
Percent of Patients with Circulatory/heart disease
Percentage of patients at hospice who had Circulatory Heart Disease as their primary diagnosis
12
Percent of Patients with Dementia
Percentage of patients at hospice who had Dementia as their primary diagnosis
37
Percent of Patients with Other Conditions
Percentage of patients at hospice who had some other conditions as their primary diagnosis
5
Percent of Patients with Respiratory disease
Percentage of patients at hospice who had Respiratory Disease as their primary diagnosis
7
Percent of Patients with Stroke
Percentage of patients at hospice who had Stroke as their primary diagnosis
4
Provided Routine Home Care and other levels of care
Th hospice had at least one incidence of routine home care and at least one more incidence of care at another level. Blank: hospice only provided care at routine home care level
Yes
Provided Routine Home Care only
The hospice had at least one incidence of RHC over the 3 years, and no incidences of care at any other level. Blank: the hospice had at least one incidence of care at another level
No

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D1073369
Facility Type
Hospice
Certificate Effective Date
September 07, 2023
Certificate Expiration Date
September 06, 2025
Laboratory Director
JULIO ANDINO-VELEZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bristol Hospice - Dallas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1952505240
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
291021001028
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 0 + 2 + 1 + 0 + 0 + 1 + 0 + 2 + 8 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1952505240 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952505240, enumerated in the NPI registry as an "organization" on June 12, 2007

The provider is located at 16901 Dallas Pkwy Ste 114 Addison, Tx 75001 and the phone number is (214) 221-9216

This medical organization specializes in Hospice Care, Community Based with taxonomy code 251G00000X

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 45D1073369 for a "hospice" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 12, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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