Angel Care Hospice of Arcadia, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

550003512 Issued in CA

Legal business name

ANGEL CARE HOSPICE OF ARCADIA, INC.

Practice address

4115 E Live Oak Ave
Arcadia, CA 91006

Phone

(818) 630-5759

Fax

(818) 237-5413

NPI assigned

May 6, 2015

Last updated

Jul 21, 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

Pargev Grigoryan

Title

President

Phone

(818) 515-3372

Specialties & licenses 2

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 1447637731. Details of each certification follow.

• CCN 921572 Hospice · Active · Details

Hospice certification: CCN 921572

Legal name

ANGEL CARE HOSPICE OF ARCADIA INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 1, 2016

Last certification

Sep 19, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 27, 2015 in CA

Enrollment address

4115 E Live Oak Ave
Ste 10
Arcadia, CA 91006-5820

Listed as

Angel Care Hospice of Arcadia, IncCCN 921572 · All quality measures

Ownership

For-Profit

Certified

Dec 1, 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

Locations

All disclosed owners & managing parties 6

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 3

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

• Lynn Ly, NP

  • Nurse Practitioner
  • Baldwin Park, CA
  • NPI 1154809804

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Francis Alejandro Mendez Munduate, M.D.

  • Hospitalist Physician
  • Pomona, CA
  • NPI 1659614121

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership
• Jeffrey Scott Shapiro, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1760588776

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

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

• Francis Alejandro Mendez Munduate, M.D.

  • Hospitalist Physician
  • Pomona, CA
  • NPI 1659614121

  Hospice

  Care Compare affiliation
• Jeffrey Scott Shapiro, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1760588776

  Hospice

  Care Compare affiliation
• Paul Stanley Usborne, M.D.

  • Family Medicine Physician
  • Covina, CA
  • NPI 1871513077

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447637731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 E. LIVE OAK AVE.",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "818-630-5759",
            "fax_number": "818-237-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 E LIVE OAK AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "818-630-5759",
            "fax_number": "818-237-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL CARE HOSPICE OF ARCADIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "PARGEV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-515-3372"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "550003512",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Arcadia, CA
• Providers in Arcadia, 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 Jul 21, 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.