Eagle Glen Hospice Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EAGLE GLEN HOSPICE CARE

Practice address

27349 Jefferson Ave Ste 214
Temecula, CA 92590-5634

Phone

(951) 376-1064

Fax

(877) 495-2050

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Patricia A Shader, RN

Title

Administrator

Phone

(760) 566-8867

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B31588

Legal name

EAGLE GLEN HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 16, 2021

Last certification

Dec 16, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 12, 2020 in CA

Enrollment address

27349 Jefferson Ave
Ste 214
Temecula, CA 92590-5634

Listed as

Eagle Glen Hospice CareCCN B31588

Certified

Dec 16, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 5

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.

• Genaro Martinez, M.D.

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1235157843

  Contracted 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.

• Kasha Farahani, DPT

  • Physical Therapist
  • San Diego, CA
  • NPI 1902026040
  NPD

Affiliated clinicians 1

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

• Genaro Martinez, M.D.

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1235157843

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1114513710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27349 JEFFERSON AVE STE 214",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905634",
            "telephone_number": "951-376-1064",
            "fax_number": "877-495-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27349 JEFFERSON AVE STE 214",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905634",
            "telephone_number": "951-376-1064",
            "fax_number": "877-495-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE GLEN HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "SHADER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-566-8867",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Durling Recovery, LLC
• Yana Alexandra Durmashkin, MD
• Pamela Michele Dyer, M.A. LMFT
• Brian Dykstra, MD
• E.M. Dresbach MD, Inc.
• Kala Chrisilis Earley, ATC
• Early Education Center for Autism (Eeca)
• Elicia Echegoyen
• Joseph Echevarria
• Dwight Winslow Eckard, D.D.S.

• Community Based Hospice Care Agency in Temecula, CA
• Providers in Temecula, 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 Apr 21, 2025; 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.