Divine Hospice and Palliative Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

DIVINE HOSPICE AND PALLIATIVE CARE LLC

Doing business as

Divine Hospice and Palliative Care LLC

Practice address

18185 N 83Rd Ave Ste 203
Glendale, AZ 85308-0523

Phone

(623) 566-7995

Fax

(602) 733-6487

NPI assigned

Nov 20, 2014

Organization subpart

No

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

Authorized official

Name

Rikesh DesaiNPI 1396966743

Title

Owner

Phone

(623) 566-7995

Specialties & licenses 1

Addresses

Other names 1

• Divine Hospice and Palliative Care LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Hospice certification: CCN 031649

Legal name

DIVINE HOSPICE AND PALLIATIVE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 20, 2016

Last certification

Oct 17, 2019

Ownership / control type

Other

Organization structure

LLCProprietary

Incorporated

May 20, 2016 in AZ

Enrollment address

18185 N 83Rd Ave
Ste 203
Glendale, AZ 85308-0523

Listed as

Divine Hospice and Palliative Care, LLCCCN 031649 · All quality measures

Ownership

Other

Certified

May 20, 2016

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 1

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.

• Rikesh Rajendra Desai, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Surprise, AZ
  • NPI 1396966743

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rikesh Rajendra Desai, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Surprise, AZ
  • NPI 1396966743
  NPD Authorized official

Affiliated clinicians 1

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

• Rikesh Rajendra Desai, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Surprise, AZ
  • NPI 1396966743

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1104223106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE STE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080523",
            "telephone_number": "623-566-7995",
            "fax_number": "602-733-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE STE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080523",
            "telephone_number": "623-566-7995",
            "fax_number": "602-733-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "RIKESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-566-7995"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Hospice and Palliative Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Diner, RN, BSN
• Dana Dion
• Joseph Anthony Dipasquale, MD
• Evan Dittrich
• Divine Grace LLC
• Brittany Marie Divito, NP
• Marissa Danielle Divito
• Victoria Friedman Dixon, DMD
• Kenneth Dizon, DO
• Nasser Djavadi, MD

• Community Based Hospice Care Agency in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.