NPIMap

Organization Active NPI

United Healthcare Hospice, Inc

  • Community Based Hospice Care Agency
  • Reseda, CA
National Provider Identifier
1497365233
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
UNITED HEALTHCARE HOSPICE, INC
Practice address
18747 Sherman Way Ste 101
Reseda, CA 91335-4000
Phone
(818) 674-4863
NPI assigned
Aug 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Mr. Benedicto Briones Jr.
Title
Ceo
Phone
(213) 973-4087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

18747 Sherman Way Ste 101
Reseda, CA 91335-4000

Mailing address

18747 Sherman Way Ste 101
Reseda, CA 91335-4000
Phone (818) 674-4863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200828001988 CA Part A Provider - Hospice 2365869864 Practice locations: Reseda, CA

Hospice certification: CCN B31666

Legal name
UNITED HEALTHCARE HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 24, 2021
Last certification
Nov 24, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 28, 2020 in CA
Enrollment address
18747 Sherman Way
Ste 101
Reseda, CA 91335-4000

Care Compare: Hospice

Medicare Care Compare
Listed as
United Healthcare Hospice, IncCCN B31666 · All quality measures
Certified
Nov 24, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

18747 Sherman Way
Ste 101
Reseda, CA 91335
Phone (213) 973-4087

Ownership & related parties

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.

NameRoleSinceShare
Joshua C Tagum Individual 5% Or Greater Direct Ownership Interest Dec 5, 2022 95%
Corporate OfficerDirector and 95% Owner Dec 5, 2022 95%
Corporate DirectorDirector and 95% Owner Dec 5, 2022 95%
W-2 Managing EmployeeDirector and 95% Owner Dec 5, 2022 95%
Benedicto B Briones Individual 5% Or Greater Direct Ownership Interest Dec 5, 2022 5%
Corporate OfficerCeo,Cfo,Secretary,Board Member Dec 5, 2022 5%
Corporate DirectorCeo,Cfo,Secretary,Board Member Dec 5, 2022 5%
W-2 Managing EmployeeCeo,Cfo,Secretary,Board Member Dec 5, 2022 5%
Salve N Tabi Individual W-2 Managing EmployeeAd; Apr 20, 2024
Eric Cui Individual Contracted Managing EmployeeMD; Aug 30, 2023

Owners & managing parties with NPI records 1

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

  • Eric Cui
    • Internal Medicine Physician
    • Monterey Park, CA
    • NPI 1003342395

    Contracted Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1497365233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18747 SHERMAN WAY STE 101",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354000",
            "telephone_number": "818-674-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18747 SHERMAN WAY STE 101",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354000",
            "telephone_number": "818-674-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEALTHCARE HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "BRIONES",
        "authorized_official_first_name": "BENEDICTO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-973-4087",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.