Pacific Crest Hospice of Ventura County, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PACIFIC CREST HOSPICE OF VENTURA COUNTY, LLC

Practice address

2300 Alessandro Dr Ste 120
Ventura, CA 93001-3783

Phone

(714) 673-6810

NPI assigned

Dec 8, 2020

Last updated

Dec 8, 2020By 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

Jose Lynch

Title

Manager

Phone

(714) 673-6810

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 1578169249. Details of each certification follow.

• CCN B51565 Hospice · Active · Details

Hospice certification: CCN B51565

Legal name

PACIFIC CREST HOSPICE OF VENTURA COUNTY, LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 19, 2023

Last certification

Jan 19, 2023

Organization structure

LLCProprietary

Incorporated

Aug 19, 2020 in CA

Enrollment address

2300 Alessandro Dr
Ste 120
Ventura, CA 93001-3783

Listed as

Pacific Crest Hospice of Ventura County LLCCCN B51565 · All quality measures

Certified

Jan 19, 2023

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 13

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 2

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

• Ali Esmaili, MD

  • Internal Medicine Physician
  • Ventura, CA
  • NPI 1033390562

  Contracted Managing Employee

  CMS ownership
• Huy Thanh Ho, M.D.

  • Specialist
  • San Diego, CA
  • NPI 1750370458

  W-2 Managing Employee

  CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Copper Falls Hospice LLC

  • Community Based Hospice Care Agency
  • Meridian, ID
  • NPI 1881468189

  Max DL, LLC

  CMS ownership

Affiliated clinicians 1

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

• Ali Esmaili, MD

  • Internal Medicine Physician
  • Ventura, CA
  • NPI 1033390562

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1578169249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 ALESSANDRO DR STE 120",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 ALESSANDRO DR STE 120",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013783",
            "telephone_number": "714-673-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CREST HOSPICE OF VENTURA COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-673-6810"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pacific Inpatient Physicians
• Pacific Pain Management, Inc.
• Pacific Therapy Services, Inc
• Pacificaspine,PC
• Gennevieve Kae Paddelford-Virovko

• Community Based Hospice Care Agency in Ventura, CA
• Providers in Ventura, 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 8, 2020; 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.