Advent Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ADVENT HOSPICE LLC

Practice address

4025 E Chandler Blvd Ste 52B
Phoenix, AZ 85048-8832

Phone

(602) 284-8730

Fax

(480) 550-8558

NPI assigned

Jan 14, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Vequilla Dinglasan, RN

Title

Director of Nursing

Phone

(602) 284-8730

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Hospice certification: CCN 001565

Legal name

ADVENT HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 16, 2023

Last certification

Jul 25, 2023

Organization structure

LLCProprietary

Incorporated

Jan 13, 2022 in AZ

Enrollment address

4025 E Chandler Blvd
Ste 52B
Phoenix, AZ 85048-8832

Listed as

Advent Hospice LLCCCN 001565

Certified

Aug 16, 2023

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.

• Moti Salloum, MD

  • Internal Medicine Physician
  • Cottonwood, AZ
  • NPI 1205904240

  Corporate Director

  CMS ownership

Affiliated clinicians 1

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

• Moti Salloum, MD

  • Internal Medicine Physician
  • Cottonwood, AZ
  • NPI 1205904240

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1356092001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 E CHANDLER BLVD STE 52B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488832",
            "telephone_number": "602-284-8730",
            "fax_number": "480-550-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 E CHANDLER BLVD STE 52B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488832",
            "telephone_number": "602-284-8730",
            "fax_number": "480-550-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENT HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "DINGLASAN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "VEQUILLA",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "602-284-8730",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.