Angel Valley Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ANGEL VALLEY HOSPICE LLC

Practice address

13601 Preston Rd Ste 313W
Dallas, TX 75240-4937

Phone

(469) 249-8440

NPI assigned

Jan 3, 2017

Last updated

Sep 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosalba Zavala

Title

Administrator/Ceo

Phone

(972) 896-1585

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134664915. Details of each certification follow.

• CCN 741796 Hospice · Active · Details

Hospice certification: CCN 741796

Legal name

ANGEL VALLEY HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 29, 2019

Last certification

May 29, 2019

Ownership / control type

Other

Organization structure

LLCProprietary

Incorporated

Jan 3, 2017 in TX

Enrollment address

13601 Preston Rd
Ste 313
Dallas, TX 75240-4911

Listed as

Angel Valley Hospice LLCCCN 741796 · All quality measures

Ownership

Other

Certified

May 29, 2019

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

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.

• Chirag Hargovindbhai Patel, M.D.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1669439279

  Contracted Managing Employee, Corporate Director

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chirag Hargovindbhai Patel, M.D.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1669439279
  NPD

Affiliated clinicians 2

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

• Chirag Hargovindbhai Patel, M.D.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1669439279

  Hospice

  Care Compare affiliation
• Mohammed Suhail, D.O.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1457799355

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1134664915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD STE 313W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404937",
            "telephone_number": "469-249-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD STE 313W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404937",
            "telephone_number": "469-249-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL VALLEY HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "ZAVALA",
        "authorized_official_first_name": "ROSALBA",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "972-896-1585"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.