Medcare Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MEDCARE HOSPICE LLC

Practice address

2665 Villa Creek Dr Ste 244
Dallas, TX 75234-7309

Phone

(214) 735-6622

NPI assigned

Jun 5, 2024

Last updated

Jun 5, 2024By 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

Mathew Chacko

Title

Owner

Phone

(214) 735-6622

Specialties & licenses 1

Addresses

Other names 1

• Medcare Hospice LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487495032. Details of each certification follow.

• CCN A91793 Hospice · Active · Details

Hospice certification: CCN A91793

Legal name

MEDCARE HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 6, 2025

Last certification

Aug 6, 2025

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Incorporated

Jun 5, 2024 in TX

Enrollment address

2727 LBJ Fwy
Ste 700
Dallas, TX 75234-7641

Listed as

Medcare Hospice, LLCCCN A91793 · All quality measures

Certified

Aug 6, 2025

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 4

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.

• Sumana Ketha, MD

  • Internal Medicine Physician
  • Irving, TX
  • NPI 1962447805

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1487495032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 VILLA CREEK DR STE 244",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 VILLA CREEK DR STE 244",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347309",
            "telephone_number": "214-735-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCARE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-735-6622"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medcare Hospice LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.