Pure Soul Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PURE SOUL HOSPICE, INC.

Practice address

10700 Burbank Blvd Unit 5
North Hollywood, CA 91601-2513

Phone

(818) 452-9151

NPI assigned

Apr 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peruza Daniyelyan

Title

Ceo

Phone

(661) 992-4881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Hospice certification: CCN A11655

Legal name

PURE SOUL HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 23, 2020

Last certification

Oct 23, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 28, 2019 in CA

Enrollment address

10700 Burbank Blvd
Unit 5
North Hollywood, CA 91601-2513

Listed as

Pure Soul Hospice, IncCCN A11655

Ownership

For-Profit

Certified

Oct 23, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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

Affiliated clinicians 3

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

• Daisy Ibanez Bautista, MD

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1306856992

  Hospice

  Care Compare affiliation
• Kaveh Karandish, MD

  • Internal Medicine Physician
  • Corona del Mar, CA
  • NPI 1346485919

  Hospice

  Care Compare affiliation
• Narine Misakyan, MD

  • Hospitalist Physician
  • Trenton, NJ
  • NPI 1548831266

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1639733736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 BURBANK BLVD UNIT 5",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012513",
            "telephone_number": "818-452-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 BURBANK BLVD UNIT 5",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012513",
            "telephone_number": "818-452-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE SOUL HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "DANIYELYAN",
        "authorized_official_first_name": "PERUZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-992-4881"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gil Pulde
• Marshall Pura
• Pure Hospice, Inc.
• Pure Life Home Health Care Inc
• Pure Soul Home Health Care, Inc.
• Pure Touch Hospice Care Inc
• Purex Home Health Services Inc
• Puro Physical Therapy, PC
• QMS Medical Supplies Inc
• Qna Hospice Care, Inc

• All providers in North Hollywood, CA
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.