Angel Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ANGEL HOSPICE, INC.

Practice address

30700 Telegraph Rd
Suite 2540
Bingham Farms, MI 48025-4524

Phone

(248) 593-5553

Fax

(248) 593-9120

NPI assigned

Jan 16, 2013

Last updated

May 26, 2015By 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

Sidney Billingsley

Title

Administrator

Phone

(248) 593-5553

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447598081. Details of each certification follow.

• CCN 231636 Hospice · Active · Details

Hospice certification: CCN 231636

Legal name

ANGEL HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 6, 2015

Last certification

Dec 15, 2017

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 12, 2012 in MI

Enrollment address

30700 Telegraph Rd
Ste 2540
Bingham Farms, MI 48025-4526

Listed as

Angel Hospice, IncCCN 231636 · All quality measures

Ownership

For-Profit

Certified

Jan 6, 2015

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.

Affiliated clinicians 5

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

• Russell J Anderson, DO

  • Family Medicine Physician
  • Ithaca, MI
  • NPI 1972578862

  Hospice

  Care Compare affiliation
• Eric Cary Brooks, M.D.

  • Gastroenterology Physician
  • West Bloomfield, MI
  • NPI 1689707333

  Hospice

  Care Compare affiliation
• Wahed Ishaqsei, M.D.

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1063423176

  Hospice

  Care Compare affiliation
• Jeffrey Alan Mason, DO

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1760490957

  Hospice

  Care Compare affiliation
• Ghanem Sharabi, MD

  • Internal Medicine Physician
  • Warren, MI
  • NPI 1508874504

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1447598081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30700 TELEGRAPH RD",
            "address_2": "SUITE 2540",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254524",
            "telephone_number": "248-593-5553",
            "fax_number": "248-593-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30700 TELEGRAPH RD",
            "address_2": "SUITE 2540",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254524",
            "telephone_number": "248-593-5553",
            "fax_number": "248-593-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "BILLINGSLEY",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-593-5553"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Anderson, M.D.
• Tamika Lashell Anderson
• Taylor Allissa Anderson
• Adrianna Andrade
• Tia Andrews
• Lesly Ceraly Angel
• Alison Marie Angelucci
• Hilda Anki
• Ann Inc (at home hospice)
• Elsa Antebi, MSW

• Community Based Hospice Care Agency in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Community Based Hospice Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.