Organization Active NPI

Synergy Hospice Services Inc

  • Community Based Hospice Care Agency
  • Phoenix, AZ
National Provider Identifier
1013685155
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SYNERGY HOSPICE SERVICES INC
Practice address
2432 W Peoria Ave Ste 1343
Phoenix, AZ 85029-4741
Phone
(602) 373-9483
Fax
(928) 318-8640
NPI assigned
Sep 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Maria Mercedes Rivera Valenzuela
Title
Director
Phone
(602) 373-9483

Specialties & licenses 1

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

Addresses

Primary practice location

2432 W Peoria Ave Ste 1343
Phoenix, AZ 85029-4741

Mailing address

2432 W Peoria Ave Ste 1343
Phoenix, AZ 85029-4741
Phone (602) 373-9483

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928000825 AZ Part A Provider - Hospice 7517364979 Practice locations: Phoenix, AZ

Hospice certification: CCN 031795

Legal name
SYNERGY HOSPICE SERVICES INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 13, 2022
Last certification
Apr 13, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
CorporationProprietary
Incorporated
Nov 7, 2023 in AZ
Enrollment address
2432 W Peoria Ave
Ste 1343
Phoenix, AZ 85029-4741

Care Compare: Hospice

Medicare Care Compare
Listed as
Synergy Hospice Service IncCCN 031795
Ownership
For-Profit
Certified
Apr 13, 2022
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
03D2339910Synergy Hospice Services Inc2432 N Peoria Ave Ste 1343, Phoenix, AZ 85029Certificate of waiverMar 9, 2028

National Provider Directory

National Provider Directory

Locations

2432 W Peoria Ave
Ste 1343
Phoenix, AZ 85029
Phone (602) 358-7106

4150 W Peoria Ave
Ste B118B
Phoenix, AZ 85029
Phone (602) 960-6030

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
Maria Mercedes Rivera Valenzuela Individual 5% Or Greater Direct Ownership InterestDirector/Ceo Nov 7, 2023 50%
Corporate OfficerDirector/Ceo Nov 7, 2023 50%
Corporate DirectorDirector/Ceo Nov 7, 2023 50%
W-2 Managing EmployeeAdministrator Nov 7, 2023 50%
Moses Imohi Individual W-2 Managing EmployeeMedical Director Nov 6, 2023
Sarah Bansuan Arabit Individual 5% Or Greater Direct Ownership InterestOfficer/Secretary Nov 7, 2023 50%
Corporate OfficerOfficer/Secretary Nov 7, 2023 50%
Corporate DirectorOfficer/Secretary Nov 7, 2023 50%
W-2 Managing EmployeeOfficer/Secretary Nov 7, 2023 50%

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.

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": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1013685155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 W PEORIA AVE STE 1343",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294741",
            "telephone_number": "602-373-9483",
            "fax_number": "928-318-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 W PEORIA AVE STE 1343",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294741",
            "telephone_number": "602-373-9483",
            "fax_number": "928-318-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY HOSPICE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "VALENZUELA",
        "authorized_official_first_name": "MARIA MERCEDES",
        "authorized_official_middle_name": "RIVERA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-373-9483"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.