Active NPI
Priority Hospice Care Inc.
- Community Based Hospice Care Agency
- Valley Village, CA
National Provider Identifier
1194012047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- PRIORITY HOSPICE CARE INC.
- Practice address
- 5301 Laurel Canyon Blvd. Ste.130
Valley Village, CA 91607-4968 - Phone
- (818) 676-9693
- NPI assigned
- Jun 29, 2011
- 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
- Mr. Vahagn Serobyan
- Title
- Vice President
- Phone
- (818) 676-9693
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
5301 Laurel Canyon Blvd. Ste.130
Valley Village, CA 91607-4968
Mailing address
5301 Laurel Canyon Blvd. Ste.130
Valley Village, CA 91607-4968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111013000121 | CA | Part A Provider - Hospice | 7618149741 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Covina, CA |
Hospice certification: CCN 751513
- Legal name
- PRIORITY HOSPICE CARE INC.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 19, 2013
- Last certification
- Oct 9, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 23, 2011 in CA
- Enrollment address
- 410 W Badillo St
Ste 200
Covina, CA 91723-1832
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community Based Hospice Care Agency
- Covina, CA
- NPI 1801148564
O20111013000121
Care Compare: Hospice
Medicare Care Compare- Listed as
- Priority Hospice Care, Inc
- Ownership
- For-Profit
- Certified
- Dec 19, 2013
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Priority Hospice Care Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Covina, CA
- NPI 1801148564
Locations
410 W Badillo St
Ste 200
Covina, CA 91723
Phone (626) 335-1082
5301 Laurel Canyon Blvd
Ste 130
Valley Village, CA 91607
Phone (818) 676-9693
Ownership & 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 |
|---|---|---|---|
| Byron F Garcia | 5% Or Greater Direct Ownership Interest | Aug 5, 2014 | 50% |
| Corporate Officer | Aug 5, 2014 | 50% | |
| Corporate Director | Aug 5, 2014 | 50% | |
| W-2 Managing Employee | Aug 5, 2014 | 50% | |
| Operational/Managerial Control | Aug 5, 2014 | 50% | |
| Mary Ann Llamas Garcia | 5% Or Greater Direct Ownership Interest | Aug 5, 2014 | 50% |
| Corporate Officer | Aug 5, 2014 | 50% | |
| W-2 Managing Employee | Aug 5, 2014 | 50% | |
| Operational/Managerial Control | Aug 5, 2014 | 50% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Covina, CA
- NPI 1073498457
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Glendora, CA
- NPI 1457352783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1309305600000",
"number": "1194012047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 LAUREL CANYON BLVD. STE.130",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916074968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 LAUREL CANYON BLVD. STE.130",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916074968",
"telephone_number": "818-676-9693"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIORITY HOSPICE CARE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-29",
"last_updated": "2011-06-29",
"status": "A",
"authorized_official_last_name": "SEROBYAN",
"authorized_official_first_name": "VAHAGN",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "818-676-9693",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Village, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.