Crest Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CREST HOSPICE CARE, INC.

Practice address

121 W Lexington Dr Ste 512
Glendale, CA 91203-2230

Phone

(747) 279-6776

NPI assigned

Jun 24, 2020

Last updated

Jan 17, 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

Arman Elikuchukyan

Title

Ceo

Phone

(747) 279-6772

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 1275159303. Details of each certification follow.

• CCN D61552 Hospice · Active · Details

Hospice certification: CCN D61552

Legal name

CREST HOSPICE CARE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 10, 2025

Last certification

Apr 10, 2025

Organization structure

CorporationProprietary

Incorporated

Mar 23, 2020 in CA

Enrollment address

121 W Lexington Dr
Ste 512
Glendale, CA 91203-2230

Listed as

Crest Hospice Care, Inc.CCN D61552 · All quality measures

Certified

Apr 10, 2025

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 6

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 3

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

• Rabi U. Alam, MD

  • Internal Medicine Physician
  • Van Nuys, CA
  • NPI 1821288812

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership
• Syuzanna Markosyan, FNP

  • Family Nurse Practitioner
  • Sunland, CA
  • NPI 1245075126

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Suman N Patel, MD

  • Internal Medicine Physician
  • Van Nuys, CA
  • NPI 1437225174

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Practitioners 2

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.

• Sira Azroyan

  • Registered Nurse
  • Glendale, CA
  • NPI 1518834738
  NPD
• Syuzanna Markosyan, FNP

  • Family Nurse Practitioner
  • Sunland, CA
  • NPI 1245075126
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1275159303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W LEXINGTON DR STE 512",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032230",
            "telephone_number": "747-279-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W LEXINGTON DR STE 512",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032230",
            "telephone_number": "747-279-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "ELIKUCHUKYAN",
        "authorized_official_first_name": "ARMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-279-6772"
    },
    "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 Glendale, CA
• Providers in Glendale, 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 Jan 17, 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.