Amerihealth Hospice Provider, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AMERIHEALTH HOSPICE PROVIDER, INC.

Practice address

1323 West Colton Ave.
Suite 200
Redlands, CA 92374-2868

Phone

(909) 793-7558

Fax

(909) 658-8996

NPI assigned

May 4, 2007

Last updated

Mar 7, 2023By 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

Rodrigo I Cruz

Title

Ceo

Phone

(909) 793-7558

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 1396957197. Details of each certification follow.

• CCN 551733 Hospice · Active · Details

Hospice certification: CCN 551733

Legal name

AMERIHEALTH HOSPICE PROVIDER, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 6, 2013

Last certification

Apr 4, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

1323 W Colton Ave
Ste 200
Redlands, CA 92374-2868

Listed as

Amerihealth Hospice Provider, IncCCN 551733 · All quality measures

Ownership

For-Profit

Certified

Mar 6, 2013

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.

• Sameer Ohri, MD

  • Family Medicine Physician
  • Corona, CA
  • NPI 1669669339

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Sameer Ohri, MD

  • Family Medicine Physician
  • Corona, CA
  • NPI 1669669339

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1396957197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 WEST COLTON AVE.",
            "address_2": "SUITE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742868",
            "telephone_number": "909-793-7558",
            "fax_number": "909-658-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 WEST COLTON AVE.",
            "address_2": "SUITE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742868",
            "telephone_number": "909-793-7558",
            "fax_number": "909-658-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIHEALTH HOSPICE PROVIDER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-793-7558"
    },
    "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 Redlands, CA
• Providers in Redlands, 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 Mar 7, 2023; 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.