NPIMap

Organization Active NPI

Benjamin Healthcare

  • Community Based Hospice Care Agency
  • Vallejo, CA
National Provider Identifier
1336898337
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BENJAMIN HEALTHCARE
Practice address
127 Hospital Dr Ste 202a
Vallejo, CA 94589-2500
Phone
(707) 554-4003
NPI assigned
Mar 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Steven Burningham
Title
Ceo
Phone
(415) 845-3213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

127 Hospital Dr Ste 202a
Vallejo, CA 94589-2500

Mailing address

1881 W Traverse Parkway Ste E #112
Lehi, UT 84048

Other names 1

  • Crossroads Hospice Vallejo Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190204000000 CA Part A Provider - Hospice 8628315355 Practice locations: Vallejo, CA

Hospice certification: CCN 751700

Legal name
BENJAMIN HEALTHCARE
Doing business as
CROSSROADS HOSPICE VALLEJO
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 4, 2015
Last certification
Sep 27, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jan 8, 2019 in CA
Enrollment address
127 Hospital Dr
Ste 202a
Vallejo, CA 94589-2500

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Crossroads Hospice VallejoCCN 751700
Ownership
For-Profit
Certified
Sep 4, 2015
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

127 Hospital Dr
Ste 202
Vallejo, CA 94589
Phone (707) 554-4003

127 Hospital Dr
Ste 202A
Vallejo, CA 94589
Phone (415) 770-4094

1447 N 1200 W
Orem, UT 84057
Phone (415) 770-4094

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Haben Tewolde-Davis Individual W-2 Managing EmployeeAd; Jan 30, 2023
Tyrone E Snipes Individual Contracted Managing EmployeeMD; Oct 5, 2020
Impact Socal Healthcare Inc Organization, Lehi, UT LLC 5% Or Greater Direct Ownership Interest Dec 1, 2018 100%
Steven R Burningham Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2018 25%
Corporate OfficerBoard Member Dec 1, 2018 25%
Corporate DirectorBoard Member Dec 1, 2018 25%
W-2 Managing EmployeeBoard Member Dec 1, 2018 25%
Michael L Connelly Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2018 25%
Corporate OfficerPresident/Board Member Dec 1, 2018 25%
Corporate DirectorBoard Member Dec 1, 2015 25%
Cody J Campbell Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2018 25%
Corporate OfficerPresident/Board Member Dec 1, 2018 25%
Corporate DirectorPresident/Board Member Dec 1, 2018 25%
Talmadge L Price Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2018 25%
Corporate OfficerBoard Member Dec 1, 2018 25%
Corporate DirectorBoard Member Dec 1, 2018 25%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Dec 1, 2018 Change of OwnershipThis provider was the buyer Comprehensive Home Health Care & Hospice, Inc.CCN 751700, CA, NPI 1861835936

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1336898337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 W TRAVERSE PARKWAY STE E #112",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "84048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 HOSPITAL DR STE 202A",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892500",
            "telephone_number": "707-554-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "BURNINGHAM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-845-3213"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Hospice Vallejo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Hospice Vallejo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.