Organization Active NPI

Geana Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Upland, CA
National Provider Identifier
1013388750
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GEANA HOSPICE CARE, INC.
Practice address
820 N Mountain Ave Ste 107
Upland, CA 91786-4163
Phone
(909) 367-2077
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Vardan Nazaryan
Title
Ceo
Phone
(909) 367-2077

Specialties & licenses 1

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

Addresses

Primary practice location

820 N Mountain Ave Ste 107
Upland, CA 91786-4163

Mailing address

820 N Mountain Ave Ste 107
Upland, CA 91786-4163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160323001180 CA Part A Provider - Hospice 8224335997 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013388750. Details of each certification follow.

Hospice certification: CCN 921605

Legal name
GEANA HOSPICE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 17, 2017
Last certification
Jul 15, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 24, 2013 in CA
Enrollment address
820 N Mountain Ave
Ste 107
Upland, CA 91786-4163

Care Compare: Hospice

Medicare Care Compare
Listed as
Geana Hospice Care IncCCN 921605 · All quality measures
Ownership
For-Profit
Certified
May 17, 2017
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2123891Geana Hospice Care, Inc.820 N. Mountain Ave Ste 107, Upland, CA 91786Certificate of waiverJan 4, 2027

National Provider Directory

National Provider Directory

Locations

820 N Mountain Ave
Ste 107
Upland, CA 91786
Phone (909) 301-0098

Ownership & related parties

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.

NameRoleSinceShare
Gerald P Tasin Individual 5% Or Greater Direct Ownership InterestManagerial Jun 1, 2019 100%
Corporate OfficerCeo Jun 1, 2019 100%
Corporate DirectorChairman of the Board Jun 1, 2019 100%
W-2 Managing EmployeePresident Jun 1, 2019 100%
Morgan B Garcia Individual Corporate OfficerBoard Member Jun 1, 2019 100%
Operational/Managerial ControlBoard Member Jun 1, 2019 100%
Siamak Movaghar Individual Corporate OfficerBoard Member Jun 1, 2019 100%
Operational/Managerial ControlBoard Member Jun 1, 2019 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1013388750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N MOUNTAIN AVE STE 107",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N MOUNTAIN AVE STE 107",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864163",
            "telephone_number": "909-367-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEANA HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "NAZARYAN",
        "authorized_official_first_name": "VARDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-367-2077"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.