Blendship Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BLENDSHIP INC

Practice address

222 N Mountain Ave Ste 209
Upland, CA 91786-5714

Phone

(909) 920-9400

Fax

(909) 920-5959

NPI assigned

Apr 14, 2014

Last updated

Dec 2, 2022By 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

Michelle L Doering III

Title

Ceo

Phone

(909) 920-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144649609. Details of each certification follow.

• CCN 751749 Hospice · Active · Details

Hospice certification: CCN 751749

Legal name

BLENDSHIP INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 4, 2016

Last certification

Feb 14, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 7, 2014 in CA

Enrollment address

222 N Mountain Ave
Ste 209
Upland, CA 91786-5714

Listed as

Blendship, IncCCN 751749 · All quality measures

Ownership

For-Profit

Certified

Feb 4, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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.

• Mehrdad Ghahremani-Ghajar, D.O.

  • Internal Medicine Physician
  • Rialto, CA
  • NPI 1942510607

  Contracted Managing Employee

  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.

• Salvador Lolarga Abiera III, D.P.T., P.T.

  • Geriatric Physical Therapist
  • Rialto, CA
  • NPI 1760494843
  NPD (past)

Affiliated clinicians 2

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

• Jerry Steven Garcia, MD

  • Family Medicine Physician
  • La Habra Heights, CA
  • NPI 1881617397

  Hospice

  Care Compare affiliation
• Mehrdad Ghahremani-Ghajar, D.O.

  • Internal Medicine Physician
  • Rialto, CA
  • NPI 1942510607

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1144649609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N MOUNTAIN AVE STE 209",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865714",
            "telephone_number": "909-920-9400",
            "fax_number": "909-920-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N MOUNTAIN AVE STE 209",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865714",
            "telephone_number": "909-920-9400",
            "fax_number": "909-920-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLENDSHIP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "DOERING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-920-9400",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NUMBER",
            "identifier": "C3654412",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Stephen Biscotti, D.C.
• Romany Bishay, RPH
• Shankha Suvra Biswas, MD
• Joryen Bixler
• Carey A Bledsoe, DPM
• Sasha Blissett, ND
• Blissful Living Group Home, Inc.
• Blue Horizon Hospice Inc
• Blue Pacific Hospice Care, Inc.
• Allan D Bock, MD

• Community Based Hospice Care Agency in Upland, CA
• Providers in Upland, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.