Organization Active NPI

Soleil Hospice LLC

  • Community Based Hospice Care Agency
  • San Jose, CA
National Provider Identifier
1124610696
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SOLEIL HOSPICE LLC
Practice address
800 Charcot Ave Ste 107
San Jose, CA 95131-2211
Phone
(408) 498-9945
Fax
(855) 858-4919
NPI assigned
Feb 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Authorized official

Name
Jason P Bliss
Title
Member
Phone
(408) 781-2023

Specialties & licenses 1

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

Addresses

Primary practice location

800 Charcot Ave Ste 107
San Jose, CA 95131-2211

Mailing address

800 Charcot Ave Ste 107
San Jose, CA 95131-2211
Phone (408) 498-9945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210304000769 CA Part A Provider - Hospice 8123434859 Practice locations: San Jose, CA

Hospice certification: CCN B41604

Legal name
SOLEIL HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 22, 2022
Last certification
Jun 22, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Oct 13, 2020 in CA
Enrollment address
800 Charcot Ave
Ste 107
San Jose, CA 95131-2211

Care Compare: Hospice

Medicare Care Compare
Listed as
Soleil Hospice, LLCCCN B41604
Certified
Jun 22, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

800 Charcot Ave
Ste 107
San Jose, CA 95131
Phone (408) 498-9945

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roselyn McCormack Individual 5% Or Greater Indirect Ownership InterestOwner/Managing Member/DPCS/Adm Dec 31, 2020 100%
Corporate OfficerOwner/Managing Member/DPCS/Adm Dec 31, 2020 100%
W-2 Managing EmployeeOwner/Managing Member/DPCS/Adm Dec 31, 2020 100%
Operational/Managerial ControlOwner/Managingmember/DPCS/Adm Dec 31, 2020 100%
Evelyn Cabayan Subido Individual 5% Or Greater Indirect Ownership InterestOwner/Managing Member Dec 31, 2020 100%
Corporate OfficerOwner/Managing Member Dec 31, 2020
W-2 Managing EmployeeOwner/Managingmember Feb 7, 2021
Operational/Managerial ControlOwner/Managing Member Feb 7, 2021
Jonathan M Bliss Individual 5% Or Greater Indirect Ownership InterestOwner/Managing Member Dec 31, 2020 50%
Corporate OfficerOwner/Managing Member Dec 31, 2020 100%
W-2 Managing EmployeeOwner/Managing Member Dec 31, 2020 100%
Operational/Managerial ControlOwner/Managing Member Dec 31, 2020 100%
Rosa a Faustino Individual 5% Or Greater Indirect Ownership InterestOwner/Managing Member Dec 31, 2020 15%
Corporate OfficerOwner/Managing Member Dec 31, 2020
W-2 Managing EmployeeOwner/Managing Member Dec 31, 2020
Operational/Managerial ControlArea Director of Operations Dec 31, 2020
Liahona Holdco LLC Organization, El Dorado Hills, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2020 60%
Soleil Hospice Holdco LLC Organization, San Jose, CA LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Salus Holding, LLC Organization, Sacramento, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2020 5%
Tifferic LLC Organization, San Francisco, CA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2020 20%
Jason P Bliss Individual 5% Or Greater Indirect Ownership InterestOwner/Managing Member Dec 31, 2020 50%
Corporate OfficerOwner/Managing Member Dec 31, 2020 100%
W-2 Managing EmployeeOwner/Managing Member Dec 31, 2020 100%
Operational/Managerial ControlOwner/Managing Member Dec 31, 2020 100%

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1612569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1124610696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CHARCOT AVE STE 107",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312211",
            "telephone_number": "408-498-9945",
            "fax_number": "855-858-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CHARCOT AVE STE 107",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312211",
            "telephone_number": "408-498-9945",
            "fax_number": "855-858-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLEIL HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-06",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "BLISS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "408-781-2023"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.