Premiere Hospice and Palliative Care, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PREMIERE HOSPICE AND PALLIATIVE CARE, INC.

Practice address

18645 Sherman Way Ste 106
Reseda, CA 91335-8605

Phone

(818) 697-8377

Fax

(818) 697-8387

NPI assigned

May 10, 2021

Last updated

May 10, 2021By 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

Grigor Poshotyan

Title

Ceo

Phone

(818) 697-8377

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 1669056149. Details of each certification follow.

• CCN B41774 Hospice · Active · Details

Hospice certification: CCN B41774

Legal name

PREMIERE HOSPICE AND PALLIATIVE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 22, 2022

Last certification

Jul 22, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

18645 Sherman Way
Ste 106
Reseda, CA 91335-8605

Listed as

Premiere Hospice and Pallative Care, IncCCN B41774 · All quality measures

Certified

Jul 22, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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.

• Dushyant Viswanathan, M.D.

  • Internal Medicine Physician
  • Woodland Hills, CA
  • NPI 1285897421

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Marco A Gomez Garcia, M.D.

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1265444129

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1669056149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18645 SHERMAN WAY STE 106",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358605",
            "telephone_number": "818-697-8377",
            "fax_number": "818-697-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18645 SHERMAN WAY STE 106",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913358605",
            "telephone_number": "818-697-8377",
            "fax_number": "818-697-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HOSPICE AND PALLIATIVE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "POSHOTYAN",
        "authorized_official_first_name": "GRIGOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-697-8377"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Pow
• Gloria Cecilia Prada-Quan, L.C.S.W.
• Precision Home Health Inc
• Preferred Choice Home Health Care, Inc.
• Premier Pathology Medical Laboratories Inc.
• Daniel Joseph Prescott
• Prime Residential Senior Care
• Latasha Talitha Proctor, LVN
• Professional Mammography Imaging, Inc.
• Professional Minds, PC

• Community Based Hospice Care Agency in Reseda, CA
• Providers in Reseda, 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 May 10, 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.