Serenity Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SERENITY HOSPICE LLC

Practice address

777 E Tahquitz Canyon Way
Suite 301-308
Palm Springs, CA 92262-6784

Phone

(760) 325-8718

Fax

(760) 325-8739

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Peter L. Go, RN

Title

Administrator

Phone

(760) 325-8718

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551570

Legal name

SERENITY HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 18, 2009

Last certification

Sep 9, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Enrollment address

777 E Tahquitz Canyon Way
Ste 301-308
Palm Springs, CA 92262-6784

Listed as

Serenity Hospice LLCCCN 551570

Ownership

For-Profit

Certified

Nov 18, 2009

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Owners & managing parties with NPI records 1

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

• Ziad Tannous, MD

  • Pulmonary Disease Physician
  • Palm Springs, CA
  • NPI 1235160003

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

Affiliated clinicians 2

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

• Shehryar Mahmood, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Rancho Mirage, CA
  • NPI 1659302438

  Hospice

  Care Compare affiliation
• Ravinderpal S Mann, M.D.

  • Internal Medicine Physician
  • Rancho Mirage, CA
  • NPI 1568480721

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1003098856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E TAHQUITZ CANYON WAY",
            "address_2": "SUITE 301-308",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626784",
            "telephone_number": "760-325-8718",
            "fax_number": "760-325-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E TAHQUITZ CANYON WAY",
            "address_2": "SUITE 301-308",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626784",
            "telephone_number": "760-325-8718",
            "fax_number": "760-325-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-325-8718",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anna Seo
• Kirese Yakira Serafin
• Lawrence W. Serif, D.O.
• Melgene Serrano
• Steven Session
• Severson S Palm Springs Chiropractic, Inc
• William Bradley Severson, D.C.

• Community Based Hospice Care Agency in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.