Camarillo Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CAMARILLO HOSPICE CARE, INC.

Practice address

5121 Van Nuys Blvd Suite 204
Sherman, CA 91403-5121

Phone

(818) 377-3812

Fax

(818) 380-9971

NPI assigned

Oct 29, 2014

Last updated

Jul 20, 2016By 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

Arsen Tekeian

Title

Ceo

Phone

(818) 377-3812

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144625476. Details of each certification follow.

• CCN 921693 Hospice · Active · Details

Hospice certification: CCN 921693

Legal name

CAMARILLO HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 20, 2017

Last certification

Jul 1, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

5605 Woodman Ave
Ste 205
Van Nuys, CA 91401-4703

Listed as

Camarillo Hospice Care, IncCCN 921693 · All quality measures

Ownership

For-Profit

Certified

Jul 20, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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.

• Nabil Salloum Feghali, MD

  • Internal Medicine Physician
  • Canoga Park, CA
  • NPI 1982787057

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1144625476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 VAN NUYS BLVD SUITE 204",
            "city": "SHERMAN",
            "state": "CA",
            "postal_code": "914035121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 VAN NUYS BLVD SUITE 204",
            "city": "SHERMAN",
            "state": "CA",
            "postal_code": "914035121",
            "telephone_number": "818-377-3812",
            "fax_number": "818-380-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARILLO HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "TEKEIAN",
        "authorized_official_first_name": "ARSEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-377-3812"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.