Kind Heart Hospice and Palliative Care Incorporated

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

KIND HEART HOSPICE AND PALLIATIVE CARE INCORPORATED

Practice address

160 S Old Springs Rd Ste 280
Anaheim, CA 92808-1279

Phone

(949) 674-5326

Fax

(714) 948-5911

NPI assigned

Jun 4, 2020

Last updated

Aug 27, 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

Diluvan Shabban Hassan

Title

Ceo

Phone

(949) 674-5325

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 1265056311. Details of each certification follow.

• CCN B41676 Hospice · Active · Details

Hospice certification: CCN B41676

Legal name

KIND HEART HOSPICE AND PALLIATIVE CARE INCORPORATED

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 8, 2021

Last certification

Oct 8, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 20, 2020 in CA

Enrollment address

160 S Old Springs Rd
Ste 280
Anaheim, CA 92808-1279

Listed as

Kind Heart Hospice and Palliative Care IncorporatedCCN B41676 · All quality measures

Certified

Oct 8, 2021

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 3

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.

• Sameer Ohri, MD

  • Family Medicine Physician
  • Corona, CA
  • NPI 1669669339

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Simon

  • Nurse Practitioner
  • Anaheim, CA
  • NPI 1073848628
  NPD

Affiliated clinicians 2

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

• Bassam R Bilal, M.D.

  • Internal Medicine Physician
  • Laguna Niguel, CA
  • NPI 1306890827

  Hospice

  Care Compare affiliation
• Sameer Ohri, MD

  • Family Medicine Physician
  • Corona, CA
  • NPI 1669669339

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1265056311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S OLD SPRINGS RD STE 280",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081279",
            "telephone_number": "949-674-5326",
            "fax_number": "714-948-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S OLD SPRINGS RD STE 280",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081279",
            "telephone_number": "949-674-5326",
            "fax_number": "714-948-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIND HEART HOSPICE AND PALLIATIVE CARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "DILUVAN",
        "authorized_official_middle_name": "SHABBAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-674-5325"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alethia Kindle
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• Caelan King, M.S., ATC
• Carol King, NP
• Deidra King

• Community Based Hospice Care Agency in Anaheim, CA
• Providers in Anaheim, 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 Aug 27, 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.