Journey Hospice Care Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

JOURNEY HOSPICE CARE INC.

Practice address

600 N Mountain Ave Ste C203
Upland, CA 91786-4367

Phone

(909) 252-7073

NPI assigned

Mar 21, 2017

Last updated

Apr 30, 2024By 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

Sylvie Boal

Title

Compliance

Phone

(951) 521-2273

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 1255862389. Details of each certification follow.

• CCN A01617 Hospice · Active · Details

Hospice certification: CCN A01617

Legal name

JOURNEY HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 6, 2019

Last certification

Aug 6, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 3, 2017 in CA

Enrollment address

5050 Palo Verde St
Ste 205
Montclair, CA 91763-2334

Listed as

Journey Hospice Care Inc.CCN A01617 · All quality measures

Ownership

For-Profit

Certified

Aug 6, 2019

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 1

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

• Sepehr Golboo, M.D.

  • Family Medicine Physician
  • Laguna Hills, CA
  • NPI 1164836896

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership

Affiliated clinicians 4

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

• Habib Moussa Bashoura, MD

  • Family Medicine Physician
  • La Verne, CA
  • NPI 1730170887

  Hospice

  Care Compare affiliation
• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Los Alamitos, CA
  • NPI 1770783896

  Hospice

  Care Compare affiliation
• Sepehr Golboo, M.D.

  • Family Medicine Physician
  • Laguna Hills, CA
  • NPI 1164836896

  Hospice

  Care Compare affiliation
• Calvin Purushottam Patel, MD

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1518369289

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1255862389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE STE C203",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864367",
            "telephone_number": "909-252-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE STE C203",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864367",
            "telephone_number": "909-252-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY HOSPICE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "BOAL",
        "authorized_official_first_name": "SYLVIE",
        "authorized_official_title_or_position": "COMPLIANCE",
        "authorized_official_telephone_number": "951-521-2273"
    },
    "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 Upland, CA
• Providers in Upland, 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 Apr 30, 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.