Bright Universe Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRIGHT UNIVERSE HOSPICE CARE INC

Practice address

21049 Devonshire St Ste 210B
Chatsworth, CA 91311-2375

Phone

(747) 240-3077

NPI assigned

Oct 8, 2020

Last updated

Sep 5, 2023By 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

Kristina Grigorian

Title

Ceo

Phone

(747) 240-3077

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 1629675038. Details of each certification follow.

• CCN B31614 Hospice · Active · Details

Hospice certification: CCN B31614

Legal name

BRIGHT UNIVERSE HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 23, 2021

Last certification

Nov 23, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Aug 3, 2020 in CA

Enrollment address

19634 Ventura Blvd
Ste 320
Tarzana, CA 91356-2966

Listed as

Bright Universe Hospice Care, IncCCN B31614 · All quality measures

Certified

Nov 23, 2021

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.

• L. Lee Nelson, MD

  • Emergency Medicine Physician
  • Norwalk, CA
  • NPI 1407972656

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Stephen Pine, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
  • NPI 1356352108

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1629675038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20149 DEVONSHIRE ST SUITE 210B",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "91311",
            "telephone_number": "747-240-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21049 DEVONSHIRE ST STE 210B",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112375",
            "telephone_number": "747-240-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT UNIVERSE HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "GRIGORIAN",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-240-3077"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Boyd, LCSW
• Omer Sahan Boysan, D.C.
• John Davies Bracken, MFT
• Sima Braude, MSW
• Marlon Briggs
• Mia Broker, BCBA
• Rose A Broll
• Melissa L Brooks
• Carroll Joseph Brown III, PSY.D
• Tatyana Brustinov, O.T.

• Community Based Hospice Care Agency in Chatsworth, CA
• Providers in Chatsworth, 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 Sep 5, 2023; 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.