Active NPI
Citywide Hospice Care, Inc
- Community Based Hospice Care Agency
- Burbank, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- CITYWIDE HOSPICE CARE, INC
- Practice address
- 7590 N Glenoaks Blvd Ste 103
Burbank, CA 91504-1011 - Phone
- (818) 875-4014
- NPI assigned
- Sep 4, 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
- Tatyana Sklyar
- Title
- Ceo
- Phone
- (818) 875-4014
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
7590 N Glenoaks Blvd Ste 103
Burbank, CA 91504-1011
Mailing address
7590 N Glenoaks Blvd Ste 103
Burbank, CA 91504-1011
Phone (818) 875-4014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210701002438 | CA | Part A Provider - Hospice | 1850792532 | Practice locations: Burbank, CA |
Hospice certification: CCN B31640
- Legal name
- CITYWIDE HOSPICE CARE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 7, 2021
- Last certification
- Dec 7, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 13, 2019 in CA
- Enrollment address
- 7590 N Glenoaks Blvd
Ste 103
Burbank, CA 91504-1011
Care Compare: Hospice
Medicare Care Compare- Listed as
- Citywide Hospice Care, Inc
- Certified
- Dec 7, 2021
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
7590 N Glenoaks Blvd
Ste 103
Burbank, CA 91504
Phone (818) 875-4014
8055 Foothill Blvd
Ste B
Sunland, CA 91040
Phone (818) 875-4014
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Tetyana Ustynova | 5% Or Greater Direct Ownership Interest | Sep 17, 2022 | 50% |
| Corporate Officer | Sep 17, 2022 | 50% | |
| Corporate Director | Sep 17, 2022 | 50% | |
| W-2 Managing Employee | Sep 17, 2022 | 50% | |
| Dushyant Arun Viswanathan | W-2 Managing Employee | Apr 10, 2024 | |
| Sergiy Artemchuk | 5% Or Greater Direct Ownership Interest | Sep 17, 2022 | 50% |
| Corporate Officer | Sep 17, 2022 | 50% | |
| Corporate Director | Sep 17, 2022 | 50% | |
| W-2 Managing Employee | Sep 17, 2022 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Woodland Hills, CA
- NPI 1285897421
W-2 Managing Employee
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": "1599177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666137600000",
"number": "1205440369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7590 N GLENOAKS BLVD STE 103",
"city": "BURBANK",
"state": "CA",
"postal_code": "915041011",
"telephone_number": "818-875-4014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7590 N GLENOAKS BLVD STE 103",
"city": "BURBANK",
"state": "CA",
"postal_code": "915041011",
"telephone_number": "818-875-4014"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITYWIDE HOSPICE CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-04",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A",
"authorized_official_last_name": "SKLYAR",
"authorized_official_first_name": "TATYANA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "818-875-4014"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.