Alta Hospice of California

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ALTA HOSPICE OF CALIFORNIA

Practice address

1898 N Arrowhead Ave
San Bernardino, CA 92405-4114

Phone

(866) 935-5055

Fax

(866) 935-5055

NPI assigned

May 14, 2020

Last updated

Dec 29, 2022By 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. Nareg Navasartian, RNNPI 1235898982

Title

Ceo

Phone

(866) 935-5055

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 1417579285. Details of each certification follow.

• CCN B31783 Hospice · Active · Details

Hospice certification: CCN B31783

Legal name

ALTA HOSPICE OF CALIFORNIA

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 27, 2022

Last certification

Feb 27, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 2, 2020 in CA

Enrollment address

3333 Glendale Blvd
Ste 4
Los Angeles, CA 90039-1840

Listed as

Alta Hospice of CaliforniaCCN B31783 · All quality measures

Certified

Feb 27, 2022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Nelson Petrosyan, PT, DPT

  • Physical Therapist
  • Glendale, CA
  • NPI 1053167049

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 2

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.

• Nareg Navasartian, FNP-C

  • Family Nurse Practitioner
  • Glendale, CA
  • NPI 1235898982
  NPD Authorized official
• Nelson Petrosyan, PT, DPT

  • Physical Therapist
  • Glendale, CA
  • NPI 1053167049
  NPD

Affiliated clinicians 2

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

• Argin Haritounian, DO

  • Sports Medicine (Internal Medicine) Physician
  • Glendale, CA
  • NPI 1275157828

  Hospice

  Care Compare affiliation
• Rafik Mughnetsyan, DO

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Pasadena, CA
  • NPI 1962081976
  Care Compare affiliation

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1417579285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054114",
            "telephone_number": "866-935-5055",
            "fax_number": "866-935-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054114",
            "telephone_number": "866-935-5055",
            "fax_number": "866-935-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA HOSPICE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "NAVASARTIAN",
        "authorized_official_first_name": "NAREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-935-5055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in San Bernardino, CA
• Providers in San Bernardino, 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 Dec 29, 2022; 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.