Olive Branch Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

OLIVE BRANCH HOSPICE INC.

Doing business as

Hadassa Hospice Inc.

Practice address

11428 Artesia Blvd
#27
Artesia, CA 90701-3800

Phone

(714) 941-0853

NPI assigned

Mar 7, 2017

Last updated

Mar 7, 2017By 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

Nassrein Ommi-Mazarei

Title

Secretary

Phone

(714) 941-0853

Specialties & licenses 1

Addresses

Other names 1

• Hadassa Hospice Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467992503. Details of each certification follow.

• CCN B41608 Hospice · Active · Details

Hospice certification: CCN B41608

Legal name

OLIVE BRANCH HOSPICE INC.

Doing business as

HADASSA HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 14, 2021

Last certification

Sep 14, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 3, 2017 in CA

Enrollment address

11428 Artesia Blvd
Ste 27
Artesia, CA 90701-3876

Listed as

Hadassa HospiceCCN B41608 · All quality measures

Certified

Sep 14, 2021

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.

Affiliated clinicians 3

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

• Huy Thanh Ho, M.D.

  • Specialist
  • San Diego, CA
  • NPI 1750370458

  Hospice

  Care Compare affiliation
• Jason Satria Wiguna, DO

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1346731767

  Hospice

  Care Compare affiliation
• Alexi Yarashevich, NP

  • Family Nurse Practitioner
  • Placentia, CA
  • NPI 1306340831

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1467992503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11428 ARTESIA BLVD",
            "address_2": "#27",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11428 ARTESIA BLVD",
            "address_2": "#27",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013800",
            "telephone_number": "714-941-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "OMMI-MAZAREI",
        "authorized_official_first_name": "NASSREIN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-941-0853"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hadassa Hospice Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathaniel Nodalo, COTA/L
• Jeong Sim Noh
• David Alan Nunnery
• Nurses Plus Hospice, Inc. (Nurses Plus Hospice)
• Sun Young Oh
• On Dental Corporation
• Hamlet H. Ong, D.D.S.
• Sioe Hwa Ong, DDS
• Optimal Vision Optometry PC
• Optimum Care Physical Therapy Services (Optimum Care Therapy)

• Community Based Hospice Care Agency in Artesia, CA
• Providers in Artesia, 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 Mar 7, 2017; 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.