Gravatis Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GRAVATIS HOSPICE CARE INC

Practice address

427 S Victory Blvd Ste C
Burbank, CA 91502-2353

Phone

(747) 254-3837

Fax

(747) 202-1016

NPI assigned

Feb 5, 2019

Organization subpart

No

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

Authorized official

Name

Madlen Kalashyan

Title

Ceo

Phone

(747) 254-3837

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A11676

Legal name

GRAVATIS HOSPICE CARE INC

Doing business as

FIDELIS CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 29, 2020

Last certification

Sep 29, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 19, 2018 in CA

Enrollment address

5199 E Pacific Coast Hwy
Ste 511
Long Beach, CA 90804-3375

Listed as

Fidelis CareCCN A11676

Ownership

For-Profit

Certified

Sep 29, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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

Practitioners 1

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

• Sarah Hope Goss, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1285753566
  NPD (past)

Affiliated clinicians 1

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

• Bardia Sadr, MD

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1912398785

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1295290138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 W OLIVE AVE STE 153",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021825",
            "telephone_number": "747-254-3837",
            "fax_number": "747-202-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S VICTORY BLVD STE C",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022353",
            "telephone_number": "747-254-3837",
            "fax_number": "747-202-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVATIS HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "KALASHYAN",
        "authorized_official_first_name": "MADLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-254-3837"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol B. Granados, M.S.,R.D.,C.D.E.
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• Kimberly Ann Geraldez Grava, N.P.
• Taya Lauren Gray
• Olivia Graza, FNP
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• Green Path Hospice, Inc.
• Debra Greenberg, PH.D.

• Community Based Hospice Care Agency in Burbank, CA
• Providers in Burbank, 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 Feb 5, 2019; 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.