Vivat Skilled Nursing, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VIVAT SKILLED NURSING, INC.

Practice address

411 N Central Ave Ste 302
Glendale, CA 91203-3110

Phone

(213) 477-4447

NPI assigned

Mar 5, 2019

Last updated

Mar 5, 2024By 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

Ashot Abovian

Title

Ceo

Phone

(213) 477-4447

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 1043778343. Details of each certification follow.

• CCN 559549 Home health agency · Active · Details

Home health agency certification: CCN 559549

Legal name

VIVAT SKILLED NURSING INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 16, 2021

Last certification

Aug 16, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 31, 2018 in CA

Enrollment address

411 N Central Ave
Ste 302
Glendale, CA 91203-3110

Listed as

Vivat Skilled Nursing, IncCCN 559549 · All quality measures

Overall star rating

4.5 of 5

Ownership

Proprietary

Certified

Aug 16, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

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.

Affiliated clinicians 7

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

• Robby Tony Ayoub, MD

  • Pulmonary Disease Physician
  • Huntington Beach, CA
  • NPI 1396958237

  Home health agency

  Care Compare affiliation
• Sam Baroudi, MD

  • Internal Medicine Physician
  • Vista, CA
  • NPI 1316936933

  Home health agency

  Care Compare affiliation
• Jimi O. Benson, M.D.

  • Internal Medicine Physician
  • El Cajon, CA
  • NPI 1477751667

  Home health agency

  Care Compare affiliation
• David Fahim, DO

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1396481891

  Home health agency

  Care Compare affiliation
• Syed M Hossain, M.D. .

  • Family Medicine Physician
  • Compton, CA
  • NPI 1083787907

  Home health agency

  Care Compare affiliation
• Maxwell Jen, MD

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1154688810

  Home health agency

  Care Compare affiliation
• Tsovinar Tekkelian, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Glendale, CA
  • NPI 1558447607

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1043778343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE STE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE STE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033110",
            "telephone_number": "213-477-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVAT SKILLED NURSING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "ABOVIAN",
        "authorized_official_first_name": "ASHOT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-477-4447"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gary R. Vitullo, DC
• Vivenza Medical Group Apmc
• Vivia Behavioral Services Inc
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• Thu Anh Vo, LMFT
• Rosann Volmert, D.O

• Home Health Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.