Organization Active NPI

Hospice Plus of Virginia LLC

  • Community Based Hospice Care Agency
  • Vienna, VA
National Provider Identifier
1659966455
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICE PLUS OF VIRGINIA LLC
Practice address
8500 Leesburg Pike Ste 500
Vienna, VA 22182-2409
Phone
(248) 247-9053
NPI assigned
Mar 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Rommel Pinili
Title
Owner
Phone
(248) 247-9053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

8500 Leesburg Pike Ste 500
Vienna, VA 22182-2409

Mailing address

8500 Leesburg Pike Ste 500
Vienna, VA 22182-2409
Phone (248) 247-9053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220228001811 VA Part A Provider - Hospice 4385038827 Practice locations: Vienna, VA

Hospice certification: CCN 491653

Legal name
HOSPICE PLUS OF VIRGINIA LLC
Doing business as
CAREGIVERS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 28, 2023
Last certification
Feb 16, 2023
Organization structure
LLCProprietary
Incorporated
Oct 22, 2020 in VA
Enrollment address
8500 Leesburg Pike
Ste 500
Vienna, VA 22182-2409

Care Compare: Hospice

Medicare Care Compare
Listed as
Caregivers HospiceCCN 491653
Certified
Feb 28, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2226986Hospice Plus of Virginia LLC8500 Leesburg Pike, Suite 500, Vienna, VA 22182Certificate of waiverJun 6, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Rommel-Allan Stacruz Pinili Individual 5% Or Greater Direct Ownership Interest Oct 22, 2020 25%
Corporate OfficerVP Oct 22, 2020
Corporate DirectorVP Oct 22, 2020
W-2 Managing EmployeeVP Oct 22, 2020
Eshan Ghavamifard Individual 5% Or Greater Direct Ownership Interest Oct 1, 2025 5%
Harold Ray Mertz Individual 5% Or Greater Direct Ownership Interest Oct 22, 2020 25%
Corporate OfficerTreasurer Oct 22, 2020
Corporate DirectorTreasurer Oct 22, 2020
W-2 Managing EmployeeTreasurer Oct 22, 2020
Nasser Saeidi Individual 5% Or Greater Direct Ownership Interest Oct 1, 2025 35%
Corporate OfficerPresident Oct 22, 2020
Corporate DirectorPresident Oct 22, 2020
W-2 Managing EmployeePresident Oct 22, 2020
Ivy Hormillada Individual 5% Or Greater Direct Ownership Interest Oct 1, 2025 10%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1659966455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 LEESBURG PIKE STE 500",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822409",
            "telephone_number": "248-247-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 LEESBURG PIKE STE 500",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822409",
            "telephone_number": "248-247-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE PLUS OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "PINILI",
        "authorized_official_first_name": "ROMMEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-247-9053"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.