Serenity Hospice and Palliative Care Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SERENITY HOSPICE AND PALLIATIVE CARE INC.

Practice address

9017 Reseda Blvd Ste 211
Northridge, CA 91324-3979

Phone

(818) 626-8877

NPI assigned

Jul 30, 2020

Organization subpart

No

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

Authorized official

Name

Artur Gyurdzhyan

Title

Ceo

Phone

(818) 626-8877

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B41550

Legal name

SERENITY HOSPICE AND PALLIATIVE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 20, 2022

Last certification

Apr 20, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jun 19, 2020 in CA

Enrollment address

9017 Reseda Blvd
Ste 211
Northridge, CA 91324-3979

Listed as

Serenity Hospice and Palliative CareCCN B41550

Certified

Apr 20, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 6

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.

• Nicola Faris Azar, M.D.

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1922259787

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership
• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Cypress, CA
  • NPI 1770783896

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1649889015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9017 RESEDA BLVD STE 211",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243979",
            "telephone_number": "818-626-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9017 RESEDA BLVD STE 211",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243979",
            "telephone_number": "818-626-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOSPICE AND PALLIATIVE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "GYURDZHYAN",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-626-8877"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Khrystyna Serdiuk, BI
• Sergey Sergeyevich Progushev MD Inc
• Sergey Tatulyan DDS, Inc.
• Mark Joseph Sergi, PH.D.
• Elmer J Serquina
• Bridget Serrato

• All providers in Northridge, 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, 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.