Angels Visit Hospice | NPI 1669070702

Key facts

NPI: 1669070702
Entity type: Organization (NPI type 2)
Primary specialty: Community Based Hospice Care Agency 251G00000X
Legal business name: ANGELS VISIT HOSPICE
Practice address: 21006 Devonshire St Ste 203
Chatsworth, CA 91311-2384
Phone: (818) 626-9222
NPI assigned: Oct 12, 2020
Organization subpart: No

Authorized official

Name: Shushanik Hunanyan
Title: Ceo
Phone: (818) 626-9222

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

L. Lee Nelson, MD Emergency Medicine Physician · Norwalk, CA · NPI 1407972656

CMS ownership CORPORATE DIRECTOR

Medicare Care Compare: Hospice

Listed as: Angel'S Visit Hospice CCN B31652
Certified: Dec 10, 2021
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Hospice certification: CCN B31652

Legal name: ANGEL'S VISIT HOSPICE
Certification status: Active
Provider type (POS): Hospice
Participating since: Dec 10, 2021
Last certification: Dec 10, 2021
Ownership / control type: Proprietary - Corporation
Organization structure: Corporation · Proprietary
Incorporated: Aug 14, 2020 in CA
Enrollment address: 21006 Devonshire St
Ste 203
Chatsworth, CA 91311-2384

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.

Name	Role	Since	Share
L Lee Nelson Individual	Corporate Director Medical Director	Oct 1, 2024
Nehal G Patel Individual	Corporate Director Medical Director	Dec 1, 2023
Shushanik Hunanyan Individual	5% Or Greater Direct Ownership Interest Ceo	Aug 14, 2020	100%
	Corporate Officer Ceo	Aug 14, 2020	100%
	Corporate Director Ceo	Aug 14, 2020	100%
	W-2 Managing Employee Ad;Ceo	Aug 14, 2020	100%

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20210728000143	CA	Part a Provider - Hospice	2466855580	Practice locations: Chatsworth, CA

National Provider Directory

Locations

21006 Devonshire St
Ste 203
Chatsworth, CA 91311
Phone (818) 626-9222

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community Based Hospice Care Agency	251G00000X			Yes

Addresses

Primary practice location

21006 Devonshire St Ste 203
Chatsworth, CA 91311-2384

Mailing address

21006 Devonshire St Ste 203
Chatsworth, CA 91311-2384
Phone (818) 626-9222

Other providers in Chatsworth, CA

Farideh Amin, DDS
Ann Nicole Ringpis Ancanan, REGISTERED NURSE
Laura Andrade
Marissa L Andres-Kim, MD
Angel S Visit Home Health
Liliana Anguiano, M.ED
Elena I Angulo, MSW
Anoosh Zadfar DDS, Dental Corporation
Jasmine Sino Antimo
Apluss Premier Healthcare Services, Inc.

All providers in Chatsworth, CA · Community Based Hospice Care Agency in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.