Heartford Hospice Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HEARTFORD HOSPICE CARE, INC.

Practice address

3 Park Plaza
Suite 550
Irvine, CA 92614-2537

Phone

(949) 868-3800

Fax

(949) 868-3801

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Matthew Stevenson

Title

Coo

Phone

(909) 210-1043

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heartford Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A11656

Legal name

HEARTFORD HOSPICE CARE INC

Doing business as

HEARTFORD HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 28, 2020

Last certification

Oct 28, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

3 Park PLZ
Ste 450
Irvine, CA 92614-2572

Listed as

Heartford HospiceCCN A11656

Ownership

For-Profit

Certified

Oct 28, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 7

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.

• Sanjay Prakash Muttreja, MD

  • Hospitalist Physician
  • Saint Helena, CA
  • NPI 1447201173

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 6

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

• Ketan Gokal Bhakta, MD

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1669492724

  Hospice

  Care Compare affiliation
• Jeffrey Steven Felgner, M.D.

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1790122497

  Hospice

  Care Compare affiliation
• Andrew Imparato, M.D

  • Family Medicine Physician
  • Fullerton, CA
  • NPI 1720400971

  Hospice

  Care Compare affiliation
• Angela Joy Lamotte, M.D.

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1538166764

  Hospice

  Care Compare affiliation
• Matthew Greg Lefferman, DO

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1184622417

  Hospice

  Care Compare affiliation
• Sanjay Prakash Muttreja, MD

  • Hospitalist Physician
  • Saint Helena, CA
  • NPI 1447201173

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1407317399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PARK PLZ STE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926142537",
            "telephone_number": "949-838-3800",
            "fax_number": "949-868-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PARK PLAZA",
            "address_2": "SUITE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926142537",
            "telephone_number": "949-868-3800",
            "fax_number": "949-868-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTFORD HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "909-210-1043"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A11656",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartford Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.