Amici Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AMICI HOSPICE, INC.

Practice address

7121 Magnolia Ave Ste F
Riverside, CA 92504-3805

Phone

(951) 355-5537

NPI assigned

Oct 23, 2020

Organization subpart

No

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

Authorized official

Name

Hermie A Davis

Title

Ceo/President

Phone

(909) 210-1144

Specialties & licenses 1

Addresses

Other names 1

• AMICI HOSPICE, INC. Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B51716

Legal name

AMICI HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 1, 2023

Last certification

Jan 13, 2023

Organization structure

CorporationProprietary

Incorporated

Oct 14, 2020 in CA

Enrollment address

7121 Magnolia Ave
Ste F
Riverside, CA 92504-3805

Listed as

Amici Hospice, IncCCN B51716

Certified

Feb 1, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 4

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 1

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

• Robert E Ladines, M.D.

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1033219084

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Hai Dong Nguyen, M.D.

  • Internal Medicine Physician
  • Santa Ana, CA
  • NPI 1558516963

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1053910604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7121 MAGNOLIA AVE STE F",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043805",
            "telephone_number": "951-355-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7121 MAGNOLIA AVE STE F",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043805",
            "telephone_number": "951-355-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMICI HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "HERMIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "909-210-1144"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amicihospice@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mailing address",
            "address_1": "7121 Magnolia Ave Ste F",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925043805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AMICI HOSPICE, INC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community Based Hospice Care Agency in Riverside, CA
• Providers in Riverside, 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 Oct 23, 2020; 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.