Active NPI
Superior Hospice, Inc.
- Community Based Hospice Care Agency
- Lompoc, CA
National Provider Identifier
1437790961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- SUPERIOR HOSPICE, INC.
- Practice address
- 320 E Walnut Ave Ste a
Lompoc, CA 93436-6835 - Phone
- (805) 742-4519
- NPI assigned
- Oct 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pablo Martinez
- Title
- Owner/President
- Phone
- (805) 742-4519
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
320 E Walnut Ave Ste a
Lompoc, CA 93436-6835
Mailing address
320 E Walnut Ave Ste a
Lompoc, CA 93436-6835
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200601002334 | CA | Part A Provider - Hospice | 4880015767 | Practice locations: Lompoc, CA |
Hospice certification: CCN A11519
- Legal name
- SUPERIOR HOSPICE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 9, 2020
- Last certification
- Oct 9, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 27, 2019 in CA
- Enrollment address
- 320 E Walnut Ave
Ste a
Lompoc, CA 93436-6835
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Hospice
Medicare Care Compare- Listed as
- Superior Hospice Inc
- Ownership
- For-Profit
- Certified
- Oct 9, 2020
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Superior Hospice Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nurse Practitioner
- Lompoc, CA
- NPI 1396625075
Locations
320 E Walnut Ave
Ste A
Lompoc, CA 93436
Phone (805) 742-4514
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Cassandra Lynn Pence | W-2 Managing Employee | Jan 1, 2024 | 50% |
| Lawrence B Li | W-2 Managing Employee | Apr 1, 2021 | 50% |
| Pablo Martinez | 5% Or Greater Direct Ownership Interest | Jun 27, 2019 | 50% |
| Corporate Officer | Jun 27, 2019 | 50% | |
| Corporate Director | Jun 27, 2019 | 50% | |
| Michelle Martinez | 5% Or Greater Direct Ownership Interest | Jun 27, 2019 | 50% |
| Corporate Officer | Jun 27, 2019 | 50% | |
| Corporate Director | Jun 27, 2019 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638144000000",
"number": "1437790961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E WALNUT AVE STE A",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934366835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E WALNUT AVE STE A",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934366835",
"telephone_number": "805-742-4519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPERIOR HOSPICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-06",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A",
"authorized_official_last_name": "MARTINEZ",
"authorized_official_first_name": "PABLO",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "805-742-4519"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.