Proactive Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PROACTIVE HOSPICE INC

Practice address

2777 Pacific Ave Ste L1
Long Beach, CA 90806-2625

Phone

(562) 317-8797

Fax

(562) 317-8798

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Maria Luisa G Navarro

Title

Ceo

Phone

(619) 957-3116

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B41700

Legal name

PROACTIVE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 6, 2022

Last certification

Oct 6, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jun 23, 2020 in CA

Enrollment address

2777 Pacific Ave
Ste L1
Long Beach, CA 90806-2625

Listed as

Proactive Hospice IncCCN B41700

Certified

Oct 6, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

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

• Frederick D Jenkin, PHYSICIAN

  • Family Medicine Physician
  • La Mesa, CA
  • NPI 1225069123

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1225635576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE STE L1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062625",
            "telephone_number": "562-317-8797",
            "fax_number": "562-317-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE STE L1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062625",
            "telephone_number": "562-317-8797",
            "fax_number": "562-317-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "MARIA LUISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-957-3116"
    },
    "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 Long Beach, CA
• Providers in Long Beach, 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 Oct 2, 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.