Harbor Hospice of Austin LP

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

671630

Legal business name

HARBOR HOSPICE OF AUSTIN LP

Doing business as

Beacon Hospice of Austin

Practice address

16165 Ranch Road 620 N
Austin, TX 78717-5088

Phone

(512) 443-7100

Fax

(512) 443-7109

NPI assigned

Mar 15, 2007

Last updated

Dec 16, 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

Karen Carter

Title

Exec Admin Asst

Phone

(409) 730-2046

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• BEACON HOSPICE OF AUSTIN Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053445668. Details of each certification follow.

• CCN 671630 Hospice · Active · Details

Hospice certification: CCN 671630

Legal name

HARBOR HOSPICE OF AUSTIN, LP

Doing business as

BEACON HOSPICE OF AUSTIN

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 27, 2009

Last certification

Jul 7, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

PartnershipProprietary

Enrollment address

16165 Ranch Road 620 N
Austin, TX 78717-5088

Listed as

Beacon Hospice of AustinCCN 671630 · All quality measures

Ownership

For-Profit

Certified

Jul 27, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 6

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.

• Qamar U Arfeen, M.D.

  • Pulmonary Disease Physician
  • Beaumont, TX
  • NPI 1295738649

  5% Or Greater Direct Ownership Interest, General Partnership Interest, Limited Partnership Interest, Operational/Managerial Control

  CMS ownership
• Asif S Syed, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Bertram, TX
  • NPI 1376595611

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 2

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

• Shadi Khir, MD

  • Internal Medicine Physician
  • Round Rock, TX
  • NPI 1902160534

  Hospice

  Care Compare affiliation
• Emmanuel Rodriguez Vargas, M.D.

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1992144414

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1053445668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-2332",
            "fax_number": "409-232-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16165 RANCH ROAD 620 N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787175088",
            "telephone_number": "512-443-7100",
            "fax_number": "512-443-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF AUSTIN LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXEC ADMIN ASST",
        "authorized_official_telephone_number": "409-730-2046"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "011306",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": "671630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXDADS",
            "identifier": "011306",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CCN",
            "identifier": "671630",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVER",
            "identifier": "45D1066165",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018868",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEACON HOSPICE OF AUSTIN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooks Robert Harbison
• Kaitlyn Harbison, MS, RD, LD
• Tamara Harbison, C. PED
• Harbor Health Medical Group
• Harbor Home Health LP
• Harbor Medical Equipment, LLC
• Jordan Harborth
• Cierra Harbour, RD
• Jacquelyn M Harcus
• Katherine Hardee, MED, ATC, LAT

• Community Based Hospice Care Agency in Austin, TX
• Providers in Austin, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.