NPIMap

Organization Active NPI

Amavi Hospice and Palliative Care LLC

  • Community Based Hospice Care Agency
  • McAllen, TX
National Provider Identifier
1245797935
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AMAVI HOSPICE AND PALLIATIVE CARE LLC
Practice address
5009 N McColl Rd
McAllen, TX 78504-2308
Phone
(956) 803-0081
Fax
(956) 467-1907
NPI assigned
Feb 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Victor M Benavides
Title
Alternate Administrator
Phone
(956) 867-0490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

5009 N McColl Rd
McAllen, TX 78504-2308

Mailing address

5009 N McColl Rd
McAllen, TX 78504-2308
Phone (956) 803-0081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190906002402 TX Part A Provider - Hospice 8325377922 Practice locations: McAllen, TX

Hospice certification: CCN 971564

Legal name
AMAVI HOSPICE AND PALLIATIVE CARE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 22, 2020
Last certification
Apr 22, 2020
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
in TX
Enrollment address
5009 N McColl Rd
McAllen, TX 78504-2308

Care Compare: Hospice

Medicare Care Compare
Listed as
Amavi Hospice and Palliative Care, LLCCCN 971564
Ownership
Other
Certified
Apr 22, 2020
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2169679Amavi Hospice and Palliative Care LLC5009 N McColl Road, McAllen, TX 78504Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

Locations

5009 N McColl Rd
McAllen, TX 78504
Phone (956) 803-0081

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.

NameRoleSinceShare
Blanca Quintanilla Individual 5% Or Greater Direct Ownership InterestAdmin Jul 18, 2019 30%
W-2 Managing EmployeeAdmin Jul 18, 2019 30%
Ivan G Melendez Individual Contracted Managing EmployeeMD; Mar 7, 2022
Victor Benavides Individual 5% Or Greater Direct Ownership InterestAdmin Jul 18, 2019 70%
W-2 Managing EmployeeAdmin Jul 18, 2019 70%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1245797935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 N MCCOLL RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042308",
            "telephone_number": "956-803-0081",
            "fax_number": "956-467-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 N MCCOLL RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042308",
            "telephone_number": "956-803-0081",
            "fax_number": "956-467-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAVI HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ALTERNATE ADMINISTRATOR",
        "authorized_official_telephone_number": "956-867-0490"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.