Organization Active NPI

Sierra Peak Health Inc

  • Community Based Hospice Care Agency
  • Las Vegas, NV
National Provider Identifier
1104528165
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SIERRA PEAK HEALTH INC
Practice address
4045 Spencer St Ste A45
Las Vegas, NV 89119-5245
Phone
(702) 301-8862
NPI assigned
Mar 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Janyvill Ruiz
Title
President
Phone
(702) 301-8862

Specialties & licenses 1

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

Addresses

Primary practice location

4045 Spencer St Ste A45
Las Vegas, NV 89119-5245

Mailing address

4045 Spencer St Ste A45
Las Vegas, NV 89119-5245
Phone (702) 301-8862

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230404001596 NV Part A Provider - Hospice 1759756828 Practice locations: Las Vegas, NV

Hospice certification: CCN 291647

Legal name
SIERRA PEAK HEALTH INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 14, 2023
Last certification
Sep 14, 2023
Organization structure
CorporationProprietary
Enrollment address
4045 Spencer St
Ste A45
Las Vegas, NV 89119-5245

Care Compare: Hospice

Medicare Care Compare
Listed as
Sierra Peak Health IncCCN 291647
Certified
Sep 14, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2287212Sierra Peak Health Inc4045 Spencer St Suite A45, Las Vegas, NV 89119Certificate of waiverAug 9, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Maria Imelda Deguzman Individual 5% Or Greater Direct Ownership Interest Mar 19, 2023 5%
W-2 Managing EmployeeManaging Member Mar 19, 2023 5%
Anant Kamalakar Sonpatki Individual Contracted Managing EmployeeMD; Apr 10, 2026
Janyvill M Ruiz Individual 5% Or Greater Direct Ownership Interest Mar 19, 2023 95%
Corporate Director Mar 19, 2023 95%
W-2 Managing EmployeeAd; Mar 25, 2024
Wilbert F Ching Individual Contracted Managing EmployeeMD; Apr 2, 2025

Owners & managing parties with NPI records 2

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

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": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1104528165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 SPENCER ST STE A45",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195245",
            "telephone_number": "702-301-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 SPENCER ST STE A45",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195245",
            "telephone_number": "702-301-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA PEAK HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "JANYVILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-301-8862"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.