Active NPI
MKB Consulting LLC
- Community Based Hospice Care Agency
- Palm Desert, CA
National Provider Identifier
1144838723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- MKB CONSULTING LLC
- Practice address
- 74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820 - Phone
- (800) 909-7971
- NPI assigned
- Jul 20, 2020
- 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
- Mrs. Bhavna Uppal
- Title
- Ceo
- Phone
- (800) 909-7971
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820
Mailing address
74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820
Phone (800) 909-7971
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200921002328 | CA | Part A Provider - Hospice | 5698193894 | Practice locations: Palm Desert, CA |
Hospice certification: CCN B21665
- Legal name
- MKB CONSULTING LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 15, 2021
- Last certification
- Jul 15, 2021
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC
- Incorporated
- Jun 17, 2020 in CA
- Enrollment address
- 74710 Highway 111
Ste 102
Palm Desert, CA 92260-3820
Care Compare: Hospice
Medicare Care Compare- Listed as
- MKB Consulting LLC
- Ownership
- For-Profit
- Certified
- Jul 15, 2021
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Bhavna Chaudhri | 5% Or Greater Direct Ownership Interest | Jun 20, 2020 | 99% |
| Corporate Officer | Jun 20, 2020 | 99% | |
| Luzviminda J Bergado | W-2 Managing Employee | Aug 3, 2020 | 99% |
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": "1595203200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1595203200000",
"number": "1144838723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74710 HIGHWAY 111 STE 102",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603820",
"telephone_number": "800-909-7971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74710 HIGHWAY 111 STE 102",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603820",
"telephone_number": "800-909-7971"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MKB CONSULTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-20",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A",
"authorized_official_last_name": "UPPAL",
"authorized_official_first_name": "BHAVNA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "800-909-7971",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.