Tiny Oasis Hospice , Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

TINY OASIS HOSPICE , INC

Practice address

2600 Foothill Blvd Ste 111
La Crescenta, CA 91214-4578

Phone

(747) 286-8362

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Seda Hakobyan

Title

Ceo

Phone

(747) 286-8362

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 1417536475. Details of each certification follow.

• CCN B41728 Hospice · Active · Details

Hospice certification: CCN B41728

Legal name

TINY OASIS HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 18, 2022

Last certification

Oct 18, 2022

Organization structure

CorporationProprietary

Incorporated

Jan 10, 2021 in CA

Enrollment address

2600 Foothill Blvd
Ste 111
La Crescenta, CA 91214-4501

Listed as

Tiny Oasis Hospice, IncCCN B41728 · All quality measures

Certified

Oct 18, 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.

• Gary Austin Grimes, MD

  • Family Medicine Physician
  • Palmdale, CA
  • NPI 1922172089

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Austin Grimes, MD

  • Family Medicine Physician
  • Palmdale, CA
  • NPI 1922172089
  NPD (past)

Affiliated clinicians 1

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

• Gary Austin Grimes, MD

  • Family Medicine Physician
  • Palmdale, CA
  • NPI 1922172089

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1417536475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FOOTHILL BLVD STE 111",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912144578",
            "telephone_number": "747-286-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FOOTHILL BLVD STE 111",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912144578",
            "telephone_number": "747-286-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINY OASIS HOSPICE , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "HAKOBYAN",
        "authorized_official_first_name": "SEDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-286-8362"
    },
    "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 La Crescenta, CA
• Providers in La Crescenta, 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 Apr 3, 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.