Great American Hospice Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GREAT AMERICAN HOSPICE CARE

Practice address

103 S Kenwood St Ste B
Glendale, CA 91205-1022

Phone

(818) 394-6700

NPI assigned

Jun 4, 2020

Last updated

Jun 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Narek Khachatryan

Title

Ceo

Phone

(818) 394-6700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396369427. Details of each certification follow.

• CCN B31675 Hospice · Active · Details

Hospice certification: CCN B31675

Legal name

GREAT AMERICAN HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 2, 2021

Last certification

Dec 2, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

221 W Alameda Ave
Ste 203
Burbank, CA 91502-3032

Listed as

Great American Hospice CareCCN B31675 · All quality measures

Certified

Dec 2, 2021

Medicare certification status

ActiveFrom the Provider of Services file

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.

• Mushtaq Ahmed, MD

  • Pulmonary Disease Physician
  • Bakersfield, CA
  • NPI 1033137591

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1396369427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S KENWOOD ST STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051022",
            "telephone_number": "818-394-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S KENWOOD ST STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051022",
            "telephone_number": "818-394-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT AMERICAN HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "NAREK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-394-6700"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 Jun 4, 2020; 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.