Organization Active NPI

Summerlin Hospice and Palliative Care Inc

  • Community Based Hospice Care Agency
  • Las Vegas, NV
National Provider Identifier
1043967219
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SUMMERLIN HOSPICE AND PALLIATIVE CARE INC
Practice address
4735 S Durango Dr Ste 145
Las Vegas, NV 89147-8169
Phone
(702) 331-9120
Fax
(702) 331-3782
NPI assigned
Mar 7, 2022
Last updated
Oct 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Marine Babakhanyan
Title
Administrator
Phone
(702) 551-1373

Specialties & licenses 1

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

Addresses

Primary practice location

4735 S Durango Dr Ste 145
Las Vegas, NV 89147-8169

Mailing address

4735 S Durango Dr Ste 145
Las Vegas, NV 89147-8169
Phone (702) 331-9120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220401001284 NV Part A Provider - Hospice 0547656472 Practice locations: Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043967219. Details of each certification follow.

Hospice certification: CCN 291622

Legal name
SUMMERLIN HOSPICE AND PALLIATIVE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 22, 2022
Last certification
Sep 15, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
May 18, 2021 in CA
Enrollment address
2620 Regatta Dr
Ste 102-407
Las Vegas, NV 89128-6891

Care Compare: Hospice

Medicare Care Compare
Listed as
Summerlin Hospice and Palliative Care IncCCN 291622 · All quality measures
Certified
Sep 22, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

2620 Regatta Dr
Ste 102407
Las Vegas, NV 89128
Phone (702) 331-9120

Ownership & related parties

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.

NameRoleSinceShare
Marine Babakhanyan Individual 5% Or Greater Direct Ownership InterestCeo Jun 20, 2023 50%
Corporate OfficerCeo Jun 20, 2023 50%
Corporate DirectorCeo Jun 20, 2023 50%
W-2 Managing EmployeeCeo Jun 20, 2023 50%
Peter Banyai Individual 5% Or Greater Direct Ownership InterestCfo Jun 20, 2023 50%
Corporate OfficerCfo Jun 20, 2023 50%
Corporate DirectorCfo Jun 20, 2023 50%
W-2 Managing EmployeeCfo Jun 20, 2023 50%

Practitioners & affiliated clinicians

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": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1043967219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 S DURANGO DR STE 145",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478169",
            "telephone_number": "702-331-9120",
            "fax_number": "702-331-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 S DURANGO DR STE 145",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478169",
            "telephone_number": "702-331-9120",
            "fax_number": "702-331-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERLIN HOSPICE AND PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "BABAKHANYAN",
        "authorized_official_first_name": "MARINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-551-1373"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.