Thousand Oaks Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

THOUSAND OAKS HOSPICE, INC.

Practice address

17050 Chatsworth St Ste 235
Granada Hills, CA 91344-5898

Phone

(805) 367-7040

Fax

(805) 367-4070

NPI assigned

Apr 7, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Editha M Ombra

Title

Ceo, Owner

Phone

(805) 367-7040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 921569

Legal name

THOUSAND OAKS HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 26, 2017

Last certification

Jul 22, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

17050 Chatsworth St
Ste 235
Granada Hills, CA 91344-5898

Listed as

Thousand Oaks Hospice, IncCCN 921569 · All quality measures

Ownership

For-Profit

Certified

Jan 26, 2017

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 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.

• Dushyant Viswanathan, M.D.

  • Internal Medicine Physician
  • Woodland Hills, CA
  • NPI 1285897421

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Richard Keech, M.D.

  • Family Medicine Physician
  • Huntington Park, CA
  • NPI 1487748364

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1154785004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 235",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445898",
            "telephone_number": "805-367-7040",
            "fax_number": "805-367-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 235",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445898",
            "telephone_number": "805-367-7040",
            "fax_number": "805-367-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOUSAND OAKS HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "OMBRA",
        "authorized_official_first_name": "EDITHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "805-367-7040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Granada Hills, CA
• Providers in Granada Hills, 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 Mar 21, 2024; 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.