Shepherd Living Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

016725 Issued in TX

Legal business name

SHEPHERD LIVING HOSPICE LLC

Doing business as

Four Seasons Hospice

Practice address

15420 Nacogdoches Rd
San Antonio, TX 78247

Phone

(210) 767-3870

NPI assigned

Sep 12, 2016

Organization subpart

Yes

Parent organization

SHEPHERD LIVING HOSPICEAs reported in NPPES

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

Authorized official

Name

Mona Talukdar

Title

Ceo/Owner

Phone

(210) 767-3870

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Four Seasons Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN 741631

Legal name

SHEPHERD LIVING HOSPICE LLC

Doing business as

FOUR SEASONS HEALTHCARE OF TEXAS

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 13, 2016

Last certification

Jun 18, 2021

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Incorporated

Nov 2, 2016 in TX

Enrollment address

15420 Nacogdoches Rd
San Antonio, TX 78247-1106

Listed as

All Seasons Hospice of TexasCCN 741631 · All quality measures

Ownership

For-Profit

Certified

Aug 13, 2016

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

Part of

Shepherd Living Hospice LLC

Locations

All disclosed owners & managing parties 5

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.

• Subrata Krishna Talukdar, MD

  • Cardiovascular Disease Physician
  • San Antonio, TX
  • NPI 1437149630

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 3

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

• Farah Farah, MD

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720405038

  Hospice

  Care Compare affiliation
• Michael Anthony Herzik, M.D.

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1801207873

  Hospice

  Care Compare affiliation
• Dimple Tharian, MD

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1003103128

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1437607108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471106",
            "telephone_number": "210-767-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78247",
            "telephone_number": "210-767-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD LIVING HOSPICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHEPHERD LIVING HOSPICE",
        "enumeration_date": "2016-09-12",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "TALUKDAR",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "210-767-3870"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "016725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "016725",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001029813",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Seasons Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luke Yu-Ping Shen, M.D.
• Anamika Madhukar Shende, PHYSICAL THERAPIST
• Shenila Rajani OD PLLC (Eye World)
• George Shenouda
• Shepherd Dental PC
• Alexander Shepherd, MD
• John M Shepherd, MD
• Lindsey Shepherd, DAT, LAT, ATC, CSCS
• Siena Michele Shepherd, MD
• Tristan Sean Shepherd, CNA

• Community Based Hospice Care Agency in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.