NPIMap

Organization Active NPI

Catalina Hospice PLLC

  • Community Based Hospice Care Agency
  • Tucson, AZ
National Provider Identifier
1396351235
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CATALINA HOSPICE PLLC
Practice address
3980 N Campbell Ave
Tucson, AZ 85719-1460
Phone
(520) 999-5903
Fax
(520) 336-9142
NPI assigned
Sep 16, 2020
Last updated
Nov 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Dr. Ivan Borbon, DONPI 1487036679
Title
Owner
Phone
(520) 999-5903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3980 N Campbell Ave
Tucson, AZ 85719-1460

Mailing address

PO Box 65177
Tucson, AZ 85728-5177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201217001391 AZ Part A Provider - Hospice 7214349182 Practice locations: Tucson, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396351235. Details of each certification follow.

Hospice certification: CCN 031742

Legal name
CATALINA HOSPICE PLLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 23, 2021
Last certification
Aug 23, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jul 23, 2020 in AZ
Enrollment address
3980 N Campbell Ave
Tucson, AZ 85719-1460

Care Compare: Hospice

Medicare Care Compare
Listed as
Catalina Hospice PLLCCCN 031742 · All quality measures
Ownership
For-Profit
Certified
Aug 23, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2297247Catalina Hospice3980 N Campbell Ave, Tucson, AZ 85719Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory

Locations

225 W Ajo Way
Tucson, AZ 85713
Phone (520) 268-4690

3980 N Campbell Ave
Tucson, AZ 85719
Phone (520) 322-5008

Ownership & related parties

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.

NameRoleSinceShare
Aron Baquet Individual 5% Or Greater Direct Ownership InterestDirector of Nursing Jul 23, 2020 40%
Jessica B Borbon Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Jul 23, 2020 20%
Corporate OfficerChief Executive Officer Jul 23, 2020 100%
Ivan a Borbon Individual 5% Or Greater Direct Ownership InterestMedical Director Jul 23, 2020 40%
Corporate DirectorMedical Director Jul 23, 2020 100%
Operational/Managerial Control Jul 23, 2020 100%

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

Affiliated clinicians 8

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": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1396351235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65177",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857285177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191460",
            "telephone_number": "520-999-5903",
            "fax_number": "520-336-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATALINA HOSPICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "BORBON",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-999-5903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.