Medical Alliance Group

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MEDICAL ALLIANCE GROUP

Practice address

1528 Canada Blvd Ste 203
Glendale, CA 91208-3200

Phone

(818) 915-7107

Fax

(818) 745-5519

NPI assigned

Jul 27, 2020

Organization subpart

No

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

Authorized official

Name

Edgar Ayrapetyan

Title

Ceo

Phone

(818) 915-7107

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B41785

Legal name

MEDICAL ALLIANCE GROUP

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 11, 2022

Last certification

Jul 22, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jun 14, 2019 in CA

Enrollment address

1528 Canada Blvd
Ste 203
Glendale, CA 91208-3200

Listed as

Medical Alliance GroupCCN B41785

Certified

Aug 11, 2022

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 5

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 2

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

• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Cypress, CA
  • NPI 1770783896

  Contracted Managing Employee

  CMS ownership
• Philip Kim, MD

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356781132

  Contracted 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.

• Philip Kim, MD

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356781132
  NPD (past)

Affiliated clinicians 1

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

• Philip Kim, MD

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356781132

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1447869334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 CANADA BLVD STE 203",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912083200",
            "telephone_number": "818-915-7107",
            "fax_number": "818-745-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 CANADA BLVD STE 203",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912083200",
            "telephone_number": "818-915-7107",
            "fax_number": "818-745-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ALLIANCE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "AYRAPETYAN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-915-7107"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "medicalalliancegroupinc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Business E-mail Address",
            "address_1": "1528 Canada Blvd Ste 203",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912083200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Glendale, 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 27, 2020; 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.