Madison Hospice, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MADISON HOSPICE, INC.

Practice address

1619 W Garvey Ave N Ste 107
West Covina, CA 91790-2146

Phone

(626) 727-6071

Fax

(626) 727-6075

NPI assigned

Aug 13, 2019

Last updated

Apr 9, 2025By 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

Mrs. Charlotrte Jose, RN

Title

Ceo

Phone

(909) 764-1054

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 1639725021. Details of each certification follow.

• CCN B21570 Hospice · Active · Details

Hospice certification: CCN B21570

Legal name

MADISON HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 19, 2021

Last certification

May 19, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 10, 2019 in CA

Enrollment address

1619 W Garvey Ave N
Ste 107
West Covina, CA 91790-2146

Listed as

Madison Hospice, Inc.CCN B21570 · All quality measures

Ownership

For-Profit

Certified

May 19, 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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charlotte Cueto Jose, R.N.

  • Administrator Registered Nurse
  • Fontana, CA
  • NPI 1952065856
  NPD

Affiliated clinicians 2

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

• Mehrdad Ghahremani-Ghajar, D.O.

  • Internal Medicine Physician
  • Rialto, CA
  • NPI 1942510607

  Hospice

  Care Compare affiliation
• Brittany Fernandez Wertz, DO

  • Family Medicine Physician
  • Claremont, CA
  • NPI 1396273785

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1639725021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 W GARVEY AVE N STE 107",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902146",
            "telephone_number": "626-727-6071",
            "fax_number": "626-727-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 W GARVEY AVE N STE 107",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902146",
            "telephone_number": "626-727-6071",
            "fax_number": "626-727-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "CHARLOTRTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-764-1054",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Macias
• Carolina Macias, M.A., CCC-SLP
• Enma Macias
• Yvonne Macias
• Griffin Macris
• Catherine Madrid
• Joanna Madrid
• Juan Madrigal
• Xiomara Victoria Madrigal
• Mariela Magallon-de Los Santos

• Home Health Agency in West Covina, CA
• Providers in West Covina, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.