Mar Hospice Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MAR HOSPICE CARE

Practice address

5530 Corbin Ave Ste 205
Tarzana, CA 91356-7133

Phone

(818) 600-8030

Fax

(818) 688-8079

NPI assigned

Sep 30, 2020

Organization subpart

No

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

Authorized official

Name

Alexander Mirumyan

Title

Ceo

Phone

(818) 600-8030

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 1407463763. Details of each certification follow.

• CCN B41567 Hospice · Active · Details

Hospice certification: CCN B41567

Legal name

MAR HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 4, 2022

Last certification

May 19, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jul 17, 2020 in CA

Enrollment address

5530 Corbin Ave
Ste 205
Tarzana, CA 91356-7133

Listed as

Mar Hospice CareCCN B41567 · All quality measures

Certified

Jun 4, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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.

• Paula Bailey-Walton, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1174646590

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1407463763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 CORBIN AVE STE 205",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567133",
            "telephone_number": "818-600-8030",
            "fax_number": "818-688-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 CORBIN AVE STE 205",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567133",
            "telephone_number": "818-600-8030",
            "fax_number": "818-688-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAR HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "MIRUMYAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-600-8030"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manifest Valley Wellness, LLC (Manifest Recovery Centers)
• Jacob Maniti, PT, DPT
• Alyssa Manley
• Naira Ludwigovna Manukian, M.D.
• Elizabeth Christina Manukyan
• Marble Terrace II
• Marc Cohen, M.D., Inc., a Professional Corporation
• Marcos B Fleiderman M D Medical Corporation
• Marcos Fleiderman MD Corp
• Rasha F Mardini, PSYD

• Community Based Hospice Care Agency in Tarzana, CA
• Providers in Tarzana, 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 Jan 31, 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.