Reconnect Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

RECONNECT HOSPICE INC.

Doing business as

Reconnect Hospice Inc.

Practice address

14827 Ventura Blvd Ste 207
Sherman Oaks, CA 91403-5224

Phone

(747) 264-1732

Fax

(747) 264-1764

NPI assigned

Jul 13, 2020

Last updated

Mar 20, 2024By 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

Mr. Brad Austin Nanao, LVN

Title

Ceo

Phone

(747) 264-1732

Specialties & licenses 1

Addresses

Other names 1

• Reconnect Hospice Inc. Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407474679. Details of each certification follow.

• CCN B51682 Hospice · Active · Details

Hospice certification: CCN B51682

Legal name

RECONNECT HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 4, 2022

Last certification

Oct 4, 2022

Organization structure

CorporationProprietary

Incorporated

Jun 26, 2020 in CA

Enrollment address

600 N Mountain Ave
Ste B203
Upland, CA 91786-4366

Listed as

Reconnect Hospice, IncCCN B51682 · All quality measures

Certified

Oct 4, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1407474679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14827 VENTURA BLVD STE 207",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035224",
            "telephone_number": "818-640-6497",
            "fax_number": "818-484-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14827 VENTURA BLVD STE 207",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035224",
            "telephone_number": "747-264-1732",
            "fax_number": "747-264-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONNECT HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "NANAO",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-264-1732",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "reconnecthospice@gmail.com",
            "affiliation": "N",
            "endpointDescription": "reconnecthospice@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14827 Ventura Blvd Ste 207",
            "city": "Sherman Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914035224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Reconnect Hospice Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Reconnect Hospice Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, 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 20, 2024; 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.