Bravo Hospice & Palliative Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRAVO HOSPICE & PALLIATIVE CARE

Practice address

18531 Roscoe Blvd Ste 204
Northridge, CA 91324-5467

Phone

(818) 626-9151

NPI assigned

Aug 18, 2020

Organization subpart

No

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

Authorized official

Name

Rafaela Mehvary

Title

Owner

Phone

(818) 642-4449

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21650

Legal name

BRAVO HOSPICE & PALLIATIVE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 22, 2021

Last certification

Jun 22, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

18531 Roscoe Blvd
Ste 204
Northridge, CA 91324-5467

Listed as

Bravo Hospice and Palliative CareCCN B21650

Ownership

For-Profit

Certified

Jun 22, 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.

Owners & managing parties with NPI records 1

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

• Enrique Jose Gonzalez, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1023161684

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Enrique Jose Gonzalez, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1023161684

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1487266730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18531 ROSCOE BLVD STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245467",
            "telephone_number": "818-626-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18531 ROSCOE BLVD STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245467",
            "telephone_number": "818-626-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO HOSPICE & PALLIATIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "MEHVARY",
        "authorized_official_first_name": "RAFAELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-642-4449"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.GMAIL.COM",
            "affiliation": "N",
            "address_1": "18531 Roscoe Blvd Ste 204",
            "city": "Northridge",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913245467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara Bramen
• Adrian Branche
• Alexandria Brandon
• Lindsey Rei Branker
• Lee Richard Brautman, M.D.
• Eduardo Bravo
• Breath of Sunshine Plus Inc
• Jennifer Natalie Breen Justice, MFT
• Brian'S Be Healthy Chiropractic Corporation
• Bright Minds Applied Behavior Analysis Center

• Community Based Hospice Care Agency in Northridge, CA
• Providers in Northridge, 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 Oct 19, 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.