Active NPI
Soleil Hospice LLC
- Community Based Hospice Care Agency
- San Jose, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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, LLC
- Certified
- Jun 22, 2022
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Roselyn McCormack | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 100% |
| Corporate Officer | Dec 31, 2020 | 100% | |
| W-2 Managing Employee | Dec 31, 2020 | 100% | |
| Operational/Managerial Control | Dec 31, 2020 | 100% | |
| Evelyn Cabayan Subido | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 100% |
| Corporate Officer | Dec 31, 2020 | ||
| W-2 Managing Employee | Feb 7, 2021 | ||
| Operational/Managerial Control | Feb 7, 2021 | ||
| Jonathan M Bliss | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 50% |
| Corporate Officer | Dec 31, 2020 | 100% | |
| W-2 Managing Employee | Dec 31, 2020 | 100% | |
| Operational/Managerial Control | Dec 31, 2020 | 100% | |
| Rosa a Faustino | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 15% |
| Corporate Officer | Dec 31, 2020 | ||
| W-2 Managing Employee | Dec 31, 2020 | ||
| Operational/Managerial Control | Dec 31, 2020 | ||
| Liahona Holdco LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 60% |
| Soleil Hospice Holdco LLC | 5% Or Greater Direct Ownership Interest | Dec 31, 2020 | 100% |
| Salus Holding, LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 5% |
| Tifferic LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 20% |
| Jason P Bliss | 5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 50% |
| Corporate Officer | Dec 31, 2020 | 100% | |
| W-2 Managing Employee | Dec 31, 2020 | 100% | |
| Operational/Managerial Control | Dec 31, 2020 | 100% |
Facilities with the same owner 8
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Escondido, CA
- NPI 1497347967
Liahona Holdco LLC
-
- Community Based Hospice Care Agency
- Chico, CA
- NPI 1619557667
Liahona Holdco LLC
-
- Community Based Hospice Care Agency
- American Fork, UT
- NPI 1720665433
Liahona Holdco LLC
-
- Community Based Hospice Care Agency
- Wilsonville, OR
- NPI 1487257424
Liahona Holdco LLC
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.