Soulistic Medical Institute

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOULISTIC MEDICAL INSTITUTE

Doing business as

Soulistic Hospice

Practice address

18 Calle Iglesia
Tubac, AZ 85646

Phone

(520) 398-2333

Fax

(520) 398-9524

NPI assigned

Oct 15, 2007

Last updated

May 24, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

SOULISTIC MEDICAL INSTITUTEAs reported in NPPES

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

Authorized official

Name

Catherine J Lilly

Title

Cfo

Phone

(520) 398-2333

Specialties & licenses 1

Addresses

Other names 1

• Soulistic Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386833473. Details of each certification follow.

• CCN 031577 Hospice · Active · Details

Hospice certification: CCN 031577

Legal name

SOULISTIC MEDICAL INSTITUTE

Doing business as

SOULISTIC HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 17, 2008

Last certification

Mar 3, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationNon-profit

Incorporated

Feb 27, 2006 in AZ

Enrollment address

16-18 Calle Iglesia
Tubac, AZ 85646-1990

Listed as

Soulistic HospiceCCN 031577 · All quality measures

Ownership

Other

Certified

Oct 17, 2008

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

Part of

Soulistic Medical Institute

Locations

All disclosed owners & managing parties 4

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.

• Nelson A Sandoval, MD

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1215976964

  Contracted Managing Employee

  CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Soulistic Medical Institute

  • Family Medicine Physician
  • Tubac, AZ
  • NPI 1215986104
  NPPES parent name

Practitioners 3

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.

• Marie Ann Pond, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1215348867
  NPD (past)
• Steven M Rayle, M.D.

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1104826478
  NPD (past)
• Cheryl Lynn Pate, MSN, FNP-BC

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1992048052
  NPD (past)

Affiliated clinicians 2

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

• Nelson A Sandoval, MD

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1215976964

  Hospice

  Care Compare affiliation
• Milton Howard Spivack, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1861732588

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1386833473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1990",
            "city": "TUBAC",
            "state": "AZ",
            "postal_code": "856461990",
            "telephone_number": "520-398-2333",
            "fax_number": "520-398-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CALLE IGLESIA",
            "city": "TUBAC",
            "state": "AZ",
            "postal_code": "85646",
            "telephone_number": "520-398-2333",
            "fax_number": "520-398-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULISTIC MEDICAL INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOULISTIC MEDICAL INSTITUTE",
        "enumeration_date": "2007-10-15",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "520-398-2333"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soulistic Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Soulistic Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bryce Allyn Paradis, MA, LLC
• Bradley Jay Poe
• Brianna Grace Quincy, M.D.
• Cheryl L Schultz, L.AC
• Soulistic Medical Institute
• Southern Arizona Home Care
• Thomas Linnemann DO PLLC
• Tubac Fire District
• Tubac Fire District
• Marcella Felix Zuniga

• Community Based Hospice Care Agency in Tubac, AZ
• Providers in Tubac, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.