Bridge Agency Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRIDGE AGENCY INC

Doing business as

Blue Horizon Hospice

Practice address

400 S Farrell Dr
Suite B100
Palm Springs, CA 92262-7964

Phone

(760) 904-4209

Fax

(760) 904-4189

NPI assigned

Aug 4, 2016

Last updated

Dec 12, 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

Leonard Williams

Title

Ceo/Cfo/Administrator

Phone

(760) 318-0554

Specialties & licenses 1

Addresses

Other names 1

• Blue Horizon Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174077325. Details of each certification follow.

• CCN B51794 Hospice · Active · Details

Hospice certification: CCN B51794

Legal name

BRIDGE AGENCY INC

Doing business as

BLUE HORIZON HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 12, 2023

Last certification

Sep 8, 2023

Organization structure

CorporationProprietary

Incorporated

May 24, 2016 in CA

Enrollment address

400 S Farrell Dr
Ste B100
Palm Springs, CA 92262-7961

Listed as

Blue Horizon HospiceCCN B51794 · All quality measures

Certified

Sep 12, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 7

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.

• Derek Nguyen, MD

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1528054095

  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.

• Derek Nguyen, MD

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1528054095
  NPD (past)

Affiliated clinicians 7

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

• Maritza Del Pilar De la Pena, MD

  • Internal Medicine Physician
  • Rancho Mirage, CA
  • NPI 1780911586

  Hospice

  Care Compare affiliation
• Dharmavijaypal Reddy Narayan, M.D.

  • Internal Medicine Physician
  • Palm Springs, CA
  • NPI 1215006762

  Hospice

  Care Compare affiliation
• Derek Nguyen, MD

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1528054095

  Hospice

  Care Compare affiliation
• Osmundo R Saguil, MD

  • Internal Medicine Physician
  • Palm Springs, CA
  • NPI 1346241049

  Hospice

  Care Compare affiliation
• Yehonatan Sakian, M.D.

  • Internal Medicine Physician
  • Palm Springs, CA
  • NPI 1699200097

  Hospice

  Care Compare affiliation
• Davood Vafai, M.D.

  • Hematology & Oncology Physician
  • Rancho Mirage, CA
  • NPI 1629066220

  Hospice

  Care Compare affiliation
• Stephanie S Yao, MD

  • Internal Medicine Physician
  • Rancho Mirage, CA
  • NPI 1598758690

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1174077325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S FARRELL DR",
            "address_2": "SUITE B100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922627964",
            "telephone_number": "760-318-0554",
            "fax_number": "760-904-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S FARRELL DR",
            "address_2": "SUITE B100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922627964",
            "telephone_number": "760-904-4209",
            "fax_number": "760-904-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "CEO/CFO/ADMINISTRATOR",
        "authorized_official_telephone_number": "760-318-0554"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Horizon Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Horizon Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Susan Brennan, DC
• Daniel J. Brenner, LCSW
• Eden Anne Brewster
• Brian Dunphey
• Elena Saray Bribiesca
• Dustin T Briggs, MD
• Monica Urias Brighindi
• Brighton Cardiology PC
• James Stephen Brinkman
• Corazon Cabcad Brittain, FNP-C

• Community Based Hospice Care Agency in Palm Springs, CA
• Providers in Palm Springs, 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 12, 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.