St. Bernardine Hospice Care Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ST. BERNARDINE HOSPICE CARE INC.

Practice address

6 Venture Ste 365
Irvine, CA 92618-7350

Phone

(949) 621-3700

NPI assigned

Jul 1, 2015

Last updated

Oct 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Masoud Shojaei

Title

Cfo

Phone

(949) 621-3700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255714853. Details of each certification follow.

• CCN A01528 Hospice · Active · Details

Hospice certification: CCN A01528

Legal name

ST BERNARDINE HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 22, 2018

Last certification

Aug 22, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 17, 2012 in CA

Enrollment address

6 Venture
Ste 365
Irvine, CA 92618-7350

Listed as

St Bernardine Hospice Care, IncCCN A01528 · All quality measures

Ownership

For-Profit

Certified

Aug 22, 2018

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 2

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

• Ashish Malhotra, M.D.

  • Family Medicine Physician
  • Apple Valley, CA
  • NPI 1679583744

  Contracted Managing Employee

  CMS ownership
• Arash Milani, MD

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1043581317

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

Affiliated clinicians 1

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

• Ashish Malhotra, M.D.

  • Family Medicine Physician
  • Apple Valley, CA
  • NPI 1679583744

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1255714853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VENTURE STE 365",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926187350",
            "telephone_number": "949-243-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 VENTURE STE 365",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926187350",
            "telephone_number": "949-621-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Venture",
            "address_2": "SUITE 235",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926183340",
            "country_code": "US",
            "telephone_number": "949-243-0772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. BERNARDINE HOSPICE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "SHOJAEI",
        "authorized_official_first_name": "MASOUD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-621-3700"
    },
    "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 Irvine, CA
• Providers in Irvine, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.