Tri Meadows Healthcare LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

TRI MEADOWS HEALTHCARE LLC

Practice address

8622 Reseda Blvd Ste 204
Northridge, CA 91324-4094

Phone

(818) 818-6125

NPI assigned

May 31, 2020

Organization subpart

No

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

Authorized official

Name

Irma Mejorado, RN

Title

Administrator / DPCS

Phone

(818) 818-6125

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B51678

Legal name

TRI MEADOWS HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 18, 2022

Last certification

Dec 1, 2022

Organization structure

LLCProprietary

Incorporated

Aug 25, 2019 in CA

Enrollment address

8622 Reseda Blvd
Ste 204
Northridge, CA 91324-4094

Listed as

Tri Meadows Healthcare LLCCCN B51678 · All quality measures

Certified

Dec 18, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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.

Affiliated clinicians 1

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

• Evelyn Ganaden Basco, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1669531679

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1114541729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8622 RESEDA BLVD STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244094",
            "telephone_number": "818-818-6125",
            "fax_number": "818-818-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8622 RESEDA BLVD STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244094",
            "telephone_number": "818-818-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI MEADOWS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-31",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "MEJORADO",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "ADMINISTRATOR / DPCS",
        "authorized_official_telephone_number": "818-818-6125",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hospicemd",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "office",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "office",
            "address_1": "8622 Reseda Blvd Ste 204",
            "city": "Northridge",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913244094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.