Eternal Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ETERNAL HOSPICE

Practice address

6655 W Sahara Ave Ste S-108
Las Vegas, NV 89146-0842

Phone

(708) 522-8498

NPI assigned

Mar 14, 2024

Organization subpart

No

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

Authorized official

Name

Mariya Romanovich, RN

Title

Administrator, DPCS, RN

Phone

(312) 637-0002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Hospice certification: CCN 291699

Legal name

ETERNAL HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 16, 2024

Last certification

Aug 14, 2024

Organization structure

CorporationProprietary

Incorporated

Feb 19, 2023 in NV

Enrollment address

6655 W Sahara Ave
Ste B200-108
Las Vegas, NV 89146-0842

Listed as

Eternal HospiceCCN 291699

Certified

Sep 16, 2024

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 2

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.

• Matthew Spencer Gibson, M.D.

  • Internal Medicine Physician
  • North Las Vegas, NV
  • NPI 1174843205

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Matthew Spencer Gibson, M.D.

  • Internal Medicine Physician
  • North Las Vegas, NV
  • NPI 1174843205

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1508625336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE STE S-108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "708-522-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE STE S-108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "708-522-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNAL HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "ROMANOVICH",
        "authorized_official_first_name": "MARIYA",
        "authorized_official_title_or_position": "ADMINISTRATOR, DPCS, RN",
        "authorized_official_telephone_number": "312-637-0002",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonae Etchebarren
• Lewis M Etcoff, PH.D.
• Kayvon Etebar, DO
• Ramin Etebar, MD LTD
• Eterna Medical Group LLC
• Eterne Wellness LLC
• Eternity Care Services, Inc
• Eternity of Love
• Eternity'S Path
• Eternitys Peak

• Community Based Hospice Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Based Hospice Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.