Idt Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

IDT HOSPICE CARE INC

Practice address

336 N Central Ave Ste 8
Glendale, CA 91203-3128

Phone

(818) 235-6875

Fax

(818) 688-8040

NPI assigned

May 18, 2020

Last updated

Aug 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Narine Petrosyan

Title

Administrator

Phone

(818) 235-6875

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033731617. Details of each certification follow.

• CCN B41594 Hospice · Active · Details

Hospice certification: CCN B41594

Legal name

IDT HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 7, 2022

Last certification

Mar 7, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

336 N Central Ave
Ste 8
Glendale, CA 91203-3128

Listed as

Idt Hospice Care, IncCCN B41594 · All quality measures

Certified

Mar 7, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 2

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

• Shiva Nancy Shabnam, M.D.

  • Internal Medicine Physician
  • Downey, CA
  • NPI 1679802037

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership
• Pedram Shirzad, D.O.

  • Family Medicine Physician
  • Mission Hills, CA
  • NPI 1164458816

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• Shiva Nancy Shabnam, M.D.

  • Internal Medicine Physician
  • Downey, CA
  • NPI 1679802037

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1033731617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 N CENTRAL AVE STE 8",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033128",
            "telephone_number": "818-235-6875",
            "fax_number": "818-688-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 N CENTRAL AVE STE 8",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033128",
            "telephone_number": "818-235-6875",
            "fax_number": "818-688-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDT HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "PETROSYAN",
        "authorized_official_first_name": "NARINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-235-6875"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 Aug 15, 2025; 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.