NPIMap

Organization Active NPI

Jdtje Corporation

  • Community Based Hospice Care Agency
  • Concord, CA
National Provider Identifier
1528615622
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
JDTJE CORPORATION
Practice address
3135 Clayton Rd, Suite 103
Concord, CA 94519-2796
Phone
(925) 238-3030
Fax
(925) 281-2800
NPI assigned
Aug 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Mrs. Jocelyn Capalos De la Torre, RN
Title
Administrator/Owner
Phone
(650) 922-1039

Specialties & licenses 1

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

Addresses

Primary practice location

3135 Clayton Rd, Suite 103
Concord, CA 94519-2796

Mailing address

3135 Clayton Rd, Suite 103
Concord, CA 94519-2796
Phone (925) 238-3030

Other names 1

  • Modevie Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191009002278 CA Part A Provider - Hospice 9133450968 Practice locations: Concord, CA

Hospice certification: CCN D61505

Legal name
JDTJE CORPORATION
Doing business as
MODEVIE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 1, 2023
Last certification
May 18, 2023
Organization structure
CorporationProprietary
Incorporated
Apr 23, 2019 in CA
Enrollment address
3135 Clayton Rd
Ste 103
Concord, CA 94519-2796

Care Compare: Hospice

Medicare Care Compare
Listed as
Modevie HospiceCCN D61505
Certified
Jun 1, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3135 Clayton Rd
Ste 103
Concord, CA 94519
Phone (925) 238-3030

Ownership & related parties

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.

NameRoleSinceShare
Ma Consolacion T Dimalibot Individual 5% Or Greater Direct Ownership Interest Sep 8, 2019 33.33%
Corporate OfficerTreasurer Sep 8, 2019 30%
Janet a Valencia Individual 5% Or Greater Direct Ownership Interest Sep 8, 2019 33.33%
Corporate OfficerVice President, Secretary, Admin Sep 8, 2019 35%
W-2 Managing EmployeeVice President, Secretary, Admin Sep 8, 2019 50%
Jocelyn C de la Torre Individual 5% Or Greater Direct Ownership Interest Sep 8, 2019 33.33%
Corporate OfficerPresident Sep 8, 2019 35%
W-2 Managing EmployeePresident, Administrator Sep 8, 2019 50%

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1528615622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 CLAYTON RD, SUITE 103",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192796",
            "telephone_number": "925-238-3030",
            "fax_number": "925-281-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 CLAYTON RD, SUITE 103",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192796",
            "telephone_number": "925-238-3030",
            "fax_number": "925-281-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JDTJE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "DE LA TORRE",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_middle_name": "CAPALOS",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "650-922-1039",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modevie Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.