St. Luke'S Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ST. LUKE'S HOSPICE, INC.

Practice address

3333 S Brea Canyon Rd
Suite 221
Diamond Bar, CA 91765-3786

Phone

(909) 444-1100

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jerry C Hermogino

Title

President

Phone

(909) 444-1100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551597

Legal name

ST. LUKE'S HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 14, 2010

Last certification

Sep 11, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 10, 2007 in CA

Enrollment address

3333 S Brea Canyon Rd
Ste 221
Diamond Bar, CA 91765-3785

Listed as

St. Luke'S Hospice, Inc.CCN 551597

Ownership

For-Profit

Certified

Dec 14, 2010

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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

• Luis A Artavia, M.D.

  • Family Medicine Physician
  • Sylmar, CA
  • NPI 1407885577

  Contracted Managing Employee

  CMS ownership
• Maria Sandra Alzona Umali, M.D.

  • Gastroenterology Physician
  • Newhall, CA
  • NPI 1790817328

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Luis A Artavia, M.D.

  • Family Medicine Physician
  • Sylmar, CA
  • NPI 1407885577

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1326227604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S BREA CANYON RD",
            "address_2": "SUITE 221",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653786",
            "telephone_number": "909-444-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S BREA CANYON RD",
            "address_2": "SUITE 221",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653786",
            "telephone_number": "909-444-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "HERMOGINO",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-444-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Souza, DPT, CHT
• Gary M Souza, DPT, OCS
• Spire Management Group, Inc.
• St Jude Hospital Yorba Linda
• St Mary'S Hospice Inc
• Douglas Starr, MD
• Victor J Steele
• Steve Li Chan MD Inc
• Nancy Jill Stoops, M.F.T
• Kent Stout, PA

• Community Based Hospice Care Agency in Diamond Bar, CA
• Providers in Diamond Bar, 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 Dec 3, 2014; 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.