Aaa Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AAA HOSPICE CARE INC

Practice address

4500 Mercantile Plaza Dr Ste 344
Fort Worth, TX 76137-4225

Phone

(817) 361-4387

NPI assigned

Jun 1, 2021

Last updated

Jun 1, 2021By 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

Marine Khachatryan

Title

Owner/Ceo

Phone

(817) 361-4387

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417523408. Details of each certification follow.

• CCN A91645 Hospice · Active · Details

Hospice certification: CCN A91645

Legal name

AAA HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 23, 2023

Last certification

Jun 1, 2023

Organization structure

CorporationProprietary

Incorporated

May 26, 2021 in TX

Enrollment address

4500 Mercantile Plaza Dr
Ste 300-344
Fort Worth, TX 76137-4225

Listed as

Aaa Hospice Care IncCCN A91645 · All quality measures

Certified

Jun 23, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1417523408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MERCANTILE PLAZA DR STE 344",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374225",
            "telephone_number": "817-361-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MERCANTILE PLAZA DR STE 344",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374225",
            "telephone_number": "817-361-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAA HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "MARINE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "817-361-4387"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.