Pride Hospice Care Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PRIDE HOSPICE CARE INC.

Practice address

2501 W Burbank Blvd Ste 206
Burbank, CA 91505-2347

Phone

(818) 333-5876

Fax

(818) 333-5875

NPI assigned

Jul 9, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Julian

Title

Administrator

Phone

(818) 333-5876

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 751752

Legal name

PRIDE HOSPICE CARE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 15, 2015

Last certification

Oct 19, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 17, 2012 in CA

Enrollment address

3033 N Avon St
Ste B
Burbank, CA 91504-2014

Listed as

Pride Hospice Care, IncCCN 751752

Ownership

For-Profit

Certified

Dec 15, 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 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.

• Edvin Dilanchiyan, MD

  • Hospitalist Physician
  • Orange, CA
  • NPI 1245483700

  Corporate Director

  CMS ownership
• Hamid Shidban, MD

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1942246111

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership
• Davine L Mercado, CRNP

  • Family Nurse Practitioner
  • Hershey, PA
  • NPI 1396230736

  Corporate Director, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Davine L Mercado, CRNP

  • Family Nurse Practitioner
  • Hershey, PA
  • NPI 1396230736
  NPD (past)

Affiliated clinicians 1

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

• Edvin Dilanchiyan, MD

  • Hospitalist Physician
  • Orange, CA
  • NPI 1245483700

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1447691282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W BURBANK BLVD STE 206",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052347",
            "telephone_number": "818-333-5876",
            "fax_number": "818-333-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W BURBANK BLVD STE 206",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052347",
            "telephone_number": "818-333-5876",
            "fax_number": "818-333-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE HOSPICE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-09",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "JULIAN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-333-5876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Burbank, CA
• Providers in Burbank, 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 Jun 20, 2016; 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.