Active NPI
Western Palliative Care, Inc.
- Community Based Hospice Care Agency
- Woodland Hills, CA
National Provider Identifier
1215218896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- WESTERN PALLIATIVE CARE, INC.
- Practice address
- 21860 Burbank Blvd Ste 180-B
Woodland Hills, CA 91367-6477 - Phone
- (818) 888-8451
- Fax
- (818) 914-4298
- NPI assigned
- Sep 8, 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
- Ms. Maria Cynthia R Puno
- Title
- President
- Phone
- (818) 804-1258
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
21860 Burbank Blvd Ste 180-B
Woodland Hills, CA 91367-6477
Mailing address
21860 Burbank Blvd Ste 180-B
Woodland Hills, CA 91367-6477
Phone (818) 888-8451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170424002040 | CA | Part A Provider - Hospice | 4385920537 | Practice locations: Woodland Hills, CA |
Hospice certification: CCN A11534
- Legal name
- WESTERN PALLIATIVE CARE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 5, 2020
- Last certification
- May 5, 2020
- Ownership / control type
- Proprietary - Individual
- Organization structure
- Corporation
- Incorporated
- Jun 13, 2010 in CA
- Enrollment address
- 21860 Burbank Blvd
Ste 180B
Woodland Hills, CA 91367-6477
Care Compare: Hospice
Medicare Care Compare- Listed as
- Western Palliative Care, Inc
- Ownership
- For-Profit
- Certified
- May 5, 2020
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2191039 | Western Palliative Care, Inc. | Certificate of waiver | Aug 20, 2026 |
National Provider Directory
National Provider DirectoryLocations
21860 Burbank Blvd
Ste 180B
Woodland Hills, CA 91367
Phone (818) 888-8451
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 |
|---|---|---|---|
| Maria Cynthia R Puno | 5% Or Greater Direct Ownership Interest | Aug 5, 2011 | 100% |
| Corporate Officer | Aug 5, 2011 | 100% | |
| Corporate Director | Aug 5, 2011 | 100% | |
| W-2 Managing Employee | Sep 9, 2016 | 100% | |
| Rolando M Rodriguez | W-2 Managing Employee | Sep 9, 2016 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1491955200000",
"number": "1215218896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21860 BURBANK BLVD STE 180-B",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676477",
"telephone_number": "818-888-8451",
"fax_number": "818-914-4298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21860 BURBANK BLVD STE 180-B",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676477",
"telephone_number": "818-888-8451",
"fax_number": "818-914-4298"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTERN PALLIATIVE CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-08",
"last_updated": "2017-04-12",
"status": "A",
"authorized_official_last_name": "PUNO",
"authorized_official_first_name": "MARIA CYNTHIA",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-804-1258",
"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": []
}
Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.