Legacy Care Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LEGACY CARE HOSPICE, INC.

Doing business as

Suncrest Hospice Care

Practice address

36923 Cook St Ste 102-1
Palm Desert, CA 92211-6073

Phone

(760) 699-0053

NPI assigned

Jan 25, 2019

Organization subpart

No

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

Authorized official

Name

Magued Barsoom

Title

Ceo

Phone

(347) 499-5358

Specialties & licenses 1

Addresses

Other names 1

• Suncrest Hospice Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A01697

Legal name

LEGACY CARE HOSPICE INC

Doing business as

SUNCREST HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 17, 2019

Last certification

Dec 17, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 4, 2018 in CA

Enrollment address

36923 Cook St
Ste 102-1
Palm Desert, CA 92211-6073

Listed as

Suncrest Hospice CareCCN A01697 · All quality measures

Ownership

For-Profit

Certified

Dec 17, 2019

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 6

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.

• Johann G. Gray, MD

  • Hospitalist Physician
  • Rancho Mirage, CA
  • NPI 1922234657

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Johann G. Gray, MD

  • Hospitalist Physician
  • Rancho Mirage, CA
  • NPI 1922234657

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1396209268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36923 COOK ST STE 102-1",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116073",
            "telephone_number": "760-699-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36923 COOK ST STE 102-1",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116073",
            "telephone_number": "760-699-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY CARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "BARSOOM",
        "authorized_official_first_name": "MAGUED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-499-5358"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suncrest Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Ramon Ledezma, CPOA CFO
• Heather Lee
• Jason M Lee
• Jonathan Lee
• McKenzie Marie Lee
• Legacy Prosthetics & Orthotics
• Legend Gardens, Inc.
• Michael Charles Leitman, PH D PSYCHOLOGY
• Karolina Lemus
• Jonne Arkin Lerner, PH.D

• Community Based Hospice Care Agency in Palm Desert, CA
• Providers in Palm Desert, 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 Apr 3, 2024; 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.