Sun City Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SUN CITY HOSPICE INC

Practice address

2780 S Jones Blvd Ste 108
Las Vegas, NV 89146-5641

Phone

(702) 333-4433

Fax

(702) 333-4352

NPI assigned

May 19, 2023

Last updated

May 19, 2023By 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

Georgiy Gelashvili

Title

Ceo

Phone

(702) 333-4433

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104517036. Details of each certification follow.

• CCN 291663 Hospice · Active · Details

Hospice certification: CCN 291663

Legal name

SUN CITY HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 16, 2023

Last certification

Aug 11, 2023

Organization structure

CorporationProprietary

Incorporated

Dec 14, 2021 in CA

Enrollment address

2780 S Jones Blvd
Ste 108
Las Vegas, NV 89146-5641

Listed as

Sun City Hospice IncCCN 291663 · All quality measures

Certified

Aug 16, 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 3

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.

• Daniel Itano, D.O.

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1194133041

  W-2 Managing Employee

  CMS ownership

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sung J Cho, PSY.D.

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1770789307
  NPD
• Sara Elizabeth Marchon, LCSW

  • Clinical Social Worker
  • Palm Beach, FL
  • NPI 1215236492
  NPD
• Thomas Eugene Williams, MSW LICSW

  • Clinical Social Worker
  • Edina, MN
  • NPI 1255431003
  NPD
• Mark Philo Short, PSY.D.

  • School Psychologist
  • Las Vegas, NV
  • NPI 1124291778
  NPD (past)
• Bonnie Marie Brown

  • Clinical Psychologist
  • Muskegon, MI
  • NPI 1801923339
  NPD (past)

Affiliated clinicians 3

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

• Jacqueline Jean Leventhal, DO

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1245494731

  Hospice

  Care Compare affiliation
• Bashir Qadir Rashid, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1942284294

  Hospice

  Care Compare affiliation
• Daniel Itano, D.O.

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1194133041

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1104517036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465641",
            "telephone_number": "702-333-4433",
            "fax_number": "702-333-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465641",
            "telephone_number": "702-333-4433",
            "fax_number": "702-333-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN CITY HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "GELASHVILI",
        "authorized_official_first_name": "GEORGIY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-333-4433"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shalysha Summit
• Deandre Lamont Summlin
• Sun City Foot Care (Summerlin Foot & Ankle)
• Sun City Medical Center PLLC
• Sun City Medical Transport
• Sun Dental Professional Corporation
• Sun Medical & Mobility Equipment
• Sun RX Drugs Inc (Sun Drugs)

• Community Based Hospice Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Based Hospice Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.