Organization Active NPI

Amatus Hospice and Palliative Care LLC

  • Community Based Hospice Care Agency
  • Farmers Branch, TX
National Provider Identifier
1013447614
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AMATUS HOSPICE AND PALLIATIVE CARE LLC
Practice address
2010 Valley View LN Ste 210
Farmers Branch, TX 75234-8915
Phone
(972) 249-4999
Fax
(972) 468-6991
NPI assigned
Jun 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Saji Raju
Title
Administrator
Phone
(972) 249-4999

Specialties & licenses 1

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

Addresses

Primary practice location

2010 Valley View LN Ste 210
Farmers Branch, TX 75234-8915

Mailing address

2010 Valley View LN Ste 210
Farmers Branch, TX 75234-8915
Phone (972) 249-4999

Other practice location 1

2410 Luna rd #141
Carrollton, TX 75006
Phone (214) 244-6801

Other practice location 2

2735 Villa Creek Dr Ste 286
Dallas, TX 75234
Phone (972) 249-4999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180124003410 TX Part A Provider - Hospice 4385903186 Practice locations: Farmers Branch, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013447614. Details of each certification follow.

Hospice certification: CCN 741737

Legal name
AMATUS HOSPICE AND PALLIATIVE CARE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 14, 2018
Last certification
Apr 15, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Apr 6, 2017 in TX
Enrollment address
2010 Valley View LN
Ste 210
Farmers Branch, TX 75234-8915

Care Compare: Hospice

Medicare Care Compare
Listed as
Amatus Hospice and Palliative Care LLCCCN 741737 · All quality measures
Ownership
For-Profit
Certified
Jun 14, 2018
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
45D2138587Amatus Hospice & Palliative Care, LLC2010 Valley View Lane Ste 210, Farmers Branch, TX 75234Certificate of waiverOct 19, 2027

National Provider Directory

National Provider Directory

Locations

2410 Luna Rd
#141
Carrollton, TX 75006
Phone (214) 244-6801

2735 Villa Creek Dr
Ste 286
Dallas, TX 75234
Phone (972) 249-4999

2010 Valley View Ln
Ste 210
Farmers Branch, TX 75234
Phone (972) 249-4999

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jeffery C Bates Individual Contracted Managing EmployeeMedical Director Mar 15, 2021
Deepa R Moparty Individual 5% Or Greater Direct Ownership InterestManagerial Sep 4, 2019 33.3%
Corporate DirectorSec/Managerial Sep 4, 2019 33.3%
Operational/Managerial ControlSec/Managerial Sep 4, 2019 33.3%
Saji Raju Individual 5% Or Greater Direct Ownership Interest Sep 4, 2019 33.35%
Corporate DirectorPres Sep 4, 2019 33.35%
Operational/Managerial ControlPres/Admin Sep 4, 2019 33.35%
Dillon K Mathew Individual 5% Or Greater Direct Ownership Interest Sep 4, 2019 33.35%
Corporate DirectorVP, Alt Admin Sep 4, 2019 33.35%
Operational/Managerial ControlVP, Alt Admin Sep 4, 2019 33.35%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013447614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 VALLEY VIEW LN STE 210",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752348915",
            "telephone_number": "972-249-4999",
            "fax_number": "972-468-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 VALLEY VIEW LN STE 210",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752348915",
            "telephone_number": "972-249-4999",
            "fax_number": "972-468-6991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 Luna rd #141",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "75006",
            "country_code": "US",
            "telephone_number": "214-244-6801",
            "fax_number": "214-432-6145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2735 Villa Creek Dr Ste 286",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75234",
            "country_code": "US",
            "telephone_number": "972-249-4999",
            "fax_number": "972-468-6991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMATUS HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-04",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "SAJI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-249-4999"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmers Branch, TX

Sources for this page

Verify at the official NPI Registry.