Fidelia Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

FIDELIA HOSPICE, INC.

Practice address

4210 Eagle Rock Blvd.
Suite 201
Los Angeles, CA 90065-4543

Phone

(562) 403-0306

Fax

(562) 332-6175

NPI assigned

May 7, 2014

Last updated

Dec 31, 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

Mr. Augusto Santos, CEO

Title

Ceo

Phone

(562) 403-0306

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568872851. Details of each certification follow.

• CCN 921701 Hospice · Active · Details

Hospice certification: CCN 921701

Legal name

FIDELIA HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 18, 2017

Last certification

Feb 21, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

4210 Eagle Rock Blvd
Ste 201
Los Angeles, CA 90065-4543

Listed as

Fidelia Hospice, Inc.CCN 921701 · All quality measures

Ownership

For-Profit

Certified

Aug 18, 2017

Medicare certification status

ActiveFrom the Provider of Services file

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.

• Anil Gupta, MD

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1538182407

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 2

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

• Luis A Artavia, M.D.

  • Family Medicine Physician
  • Sylmar, CA
  • NPI 1407885577

  Hospice

  Care Compare affiliation
• Anil Gupta, MD

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1538182407

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1568872851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 EAGLE ROCK BLVD.",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654543",
            "telephone_number": "562-403-0306",
            "fax_number": "562-332-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 EAGLE ROCK BLVD.",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654543",
            "telephone_number": "562-403-0306",
            "fax_number": "562-332-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELIA HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "AUGUSTO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-403-0306",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenton Howard Fibel, M.D.
• Mariola L Ficinski, MD
• Nichole Fickenscher
• Ficus Psych
• Mohsin Sikendar Fidai, M.D.
• Fidelis Diagnostics, Inc.
• Fidelity Speech and Voice Therapy, Inc.
• Morel Fidler, D.D.S
• Stephen Fiechter
• Charles Alexander Field

• Community Based Hospice Care Agency in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 31, 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.