Remedy Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

REMEDY HOSPICE CARE INC

Practice address

1555 E University Dr Ste 4
Mesa, AZ 85203-8142

Phone

(480) 938-9075

Fax

(480) 834-4181

NPI assigned

Jun 22, 2021

Last updated

Sep 6, 2023By 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

Theodore Agoncillo Mogol

Title

Ceo/Administrator

Phone

(480) 213-7845

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447829569. Details of each certification follow.

• CCN 031761 Hospice · Active · Details

Hospice certification: CCN 031761

Legal name

REMEDY HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 21, 2022

Last certification

Jan 21, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jun 1, 2021 in AZ

Enrollment address

1555 E University Dr
Ste 4
Mesa, AZ 85203-8142

Listed as

Remedy Hospice Care IncCCN 031761 · All quality measures

Ownership

For-Profit

Certified

Jan 21, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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.

• Richard Kim Le, D.O

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1851393003

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Richard Kim Le, D.O

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1851393003

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1447829569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 E UNIVERSITY DR STE 4",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 E UNIVERSITY DR STE 4",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038142",
            "telephone_number": "480-938-9075",
            "fax_number": "480-834-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REMEDY HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "MOGOL",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "AGONCILLO",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "480-213-7845"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.