Organization Active NPI

Capstone Hospice, LLC

  • Community Based Hospice Care Agency
  • Jersey Village, TX
National Provider Identifier
1114515657
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CAPSTONE HOSPICE, LLC
Practice address
17347 Village Green Dr Ste 109
Jersey Village, TX 77040-1164
Phone
(281) 204-2695
Fax
(281) 204-2917
NPI assigned
Jan 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
David Gober
Title
Director
Phone
(832) 867-7851

Specialties & licenses 1

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

Addresses

Primary practice location

17347 Village Green Dr Ste 109
Jersey Village, TX 77040-1164

Mailing address

17347 Village Green Dr Ste 109
Jersey Village, TX 77040-1164
Phone (281) 204-2695

Other names 1

  • Capstone Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220419002887 TX Part A Provider - Hospice 5799172896 Practice locations: Jersey Village, TX

Hospice certification: CCN A91524

Legal name
CAPSTONE HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 26, 2022
Last certification
Aug 26, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Enrollment address
17347 Village Green Dr
Ste 109
Jersey Village, TX 77040-1164

Care Compare: Hospice

Medicare Care Compare
Listed as
Capstone Hospice LLCCCN A91524
Certified
Aug 26, 2022
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
45D2289756Capstone Hospice LLC17347 Village Green Dr Suite 109, Jersey Village, TX 77040Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Michael Buxbaum Individual Contracted Managing EmployeeMD; Jun 7, 2023
Houston Care Partners, LLC Organization, Jersey Village, TX Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 20, 2020 100%
Operational/Managerial Control Dec 21, 2020 100%
David Gober Individual Corporate DirectorAlternate Administrator Dec 21, 2020
Operational/Managerial ControlCfo Dec 21, 2020 75%
Jesenia Paredes Individual Corporate OfficerOffice Manager Apr 1, 2025 100%
Kristi a Justice Individual Contracted Managing EmployeeAd; Apr 1, 2023
Corporate OfficerAdministrator Apr 1, 2025 100%
Operational/Managerial ControlAdministrator Dec 21, 2020 15%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 2

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": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1114515657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17347 VILLAGE GREEN DR STE 109",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401164",
            "telephone_number": "281-204-2695",
            "fax_number": "281-204-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17347 VILLAGE GREEN DR STE 109",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401164",
            "telephone_number": "281-204-2695",
            "fax_number": "281-204-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPSTONE HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "832-867-7851"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capstone Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capstone Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jersey Village, TX

Sources for this page

Verify at the official NPI Registry.