Encino Valley Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ENCINO VALLEY HOSPICE, INC.

Practice address

18075 Ventura Blvd Ste 227
Encino, CA 91316-3597

Phone

(818) 857-5123

Fax

(818) 857-5144

NPI assigned

Mar 11, 2020

Last updated

Mar 11, 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

Karen Garen Sukiasyan

Title

Ceo

Phone

(818) 857-5123

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 1619502481. Details of each certification follow.

• CCN B21616 Hospice · Active · Details

Hospice certification: CCN B21616

Legal name

ENCINO VALLEY HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 12, 2021

Last certification

Mar 12, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 13, 2020 in CA

Enrollment address

18075 Ventura Blvd
Ste 227
Encino, CA 91316-3597

Listed as

Encino Valley Hospice, IncCCN B21616 · All quality measures

Ownership

For-Profit

Certified

Mar 12, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

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

• Wyzscx Merfil Patacxil, M.D.

  • Surgery Physician
  • El Segundo, CA
  • NPI 1932543675

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1619502481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18075 VENTURA BLVD STE 227",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163597",
            "telephone_number": "818-857-5123",
            "fax_number": "818-857-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18075 VENTURA BLVD STE 227",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163597",
            "telephone_number": "818-857-5123",
            "fax_number": "818-857-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCINO VALLEY HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "SUKIASYAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "GAREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-857-5123"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Encino Terrace, LLC (NA)
• Encino Total Dentistry
• Encino-Tarzana Urgent Care Center, Inc.
• Harry E Enenstein, O. D.
• Enera5 (VioGene Chalcedony Aesthetics)
• Energy Physical Therapy Inc
• Lewis Anthony Engel, M.D.

• Community Based Hospice Care Agency in Encino, CA
• Providers in Encino, 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 Mar 11, 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.