Pinnacle Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

251G00000X Issued in OR

Legal business name

PINNACLE HOSPICE CARE INC

Doing business as

Pinnacle Hospice of Portland

Practice address

10570 SE Washington St
Suite 207
Portland, OR 97216

Phone

(503) 236-7454

NPI assigned

Oct 3, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Alphie De Guzman

Title

President/Owner

Phone

(503) 236-7454

Specialties & licenses 1

Addresses

Other names 1

• Pinnacle Hospice of Portland Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Hospice certification: CCN 381566

Legal name

PINNACLE HOSPICE CARE INC

Doing business as

PINNACLE HOSPICE CARE OF PORTLAND

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 10, 2017

Last certification

Aug 10, 2017

Ownership / control type

Non-Profit - Private

Organization structure

CorporationProprietary

Incorporated

Oct 3, 2011 in OR

Enrollment address

10570 SE Washington St
Ste 207
Portland, OR 97216-2846

Listed as

Pinnacle Hospice Care of PortlandCCN 381566

Ownership

Non-Profit

Certified

Aug 10, 2017

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 3

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

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1003190547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10570 SE WASHINGTON ST",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162846",
            "telephone_number": "503-236-7454",
            "fax_number": "503-323-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10570 SE WASHINGTON ST",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-236-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "ALPHIE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "503-236-7454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OR",
            "license": "251G00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Hospice of Portland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pinnacle Hospice of Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pink Wellness, LLC
• Chessa Pink
• Michele A Pinkham, PSS
• Pinko Therapeutics LLC
• Tabatha Pinkston
• Jenna Pinon
• Kelsey Pinson
• Melody Pinson
• Daphne Yvette Pinsonat, M.S.W.
• Shara Marie Lynn Pintado

• Community Based Hospice Care Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community Based Hospice Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.