Pinnacle Care Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PINNACLE CARE HOSPICE, INC.

Practice address

6934 Canby Ave Ste 111
Reseda, CA 91335-8772

Phone

(818) 839-8797

Fax

(747) 207-2615

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

Dmitry Litvishkov

Title

Owner, Ceo

Phone

(310) 709-4920

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21669

Legal name

PINNACLE CARE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 16, 2021

Last certification

Jun 16, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jul 16, 2020 in CA

Enrollment address

6934 Canby Ave
Unit 111
Reseda, CA 91335-8772

Listed as

Pinnacle Care Hospice, IncCCN B21669

Ownership

For-Profit

Certified

Jun 16, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ingrid Jackson, FNP-C

  • Nurse Practitioner
  • Montclair, CA
  • NPI 1558294421
  NPD

Affiliated clinicians 1

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

• Randall Whitaker Maxey, MD PHD

  • Nephrology Physician
  • Inglewood, CA
  • NPI 1700944279

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1013526680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6934 CANBY AVE STE 111",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358772",
            "telephone_number": "818-839-8797",
            "fax_number": "747-207-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 CANBY AVE STE 111",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358772",
            "telephone_number": "818-839-8797",
            "fax_number": "747-207-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE CARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "LITVISHKOV",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "310-709-4920"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.GMAIL.COM",
            "affiliation": "N",
            "address_1": "6934 Canby Ave Ste 111",
            "city": "Reseda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913358772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Kiana Phillips, MA, OTR/L
• Honey Harriet Pietruszka, PSY.D.
• Marvin Pietruszka, M.D.
• Mike Pirbazari, D.D.S.,M.S.,PH.D.
• Adrineh Pkhrikyan, PA-C
• Playful Expressions Speech and Language Therapy, a.P.C.
• Leo Polosajian, M.D.
• Vladimir Polyakov, D.D.S.

• Community Based Hospice Care Agency in Reseda, CA
• Providers in Reseda, 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 Jul 29, 2020; 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.