Proactive Hospice Care, LLC.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PROACTIVE HOSPICE CARE, LLC.

Practice address

52188 Van Dyke Ave Ste 201a
Shelby Township, MI 48316-3569

Phone

(586) 991-3139

NPI assigned

Apr 13, 2023

Organization subpart

No

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

Authorized official

Name

Rabia Khan

Title

Owner

Phone

(586) 785-0622

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Hospice certification: CCN 231724

Legal name

PROACTIVE HOSPICE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 16, 2024

Last certification

Oct 2, 2024

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Incorporated

Apr 12, 2023 in MI

Enrollment address

52188 Van Dyke Ave
Ste 201a
Shelby Township, MI 48316-3569

Listed as

Proactive Hospice Care, LLCCCN 231724

Certified

Oct 16, 2024

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

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

Affiliated clinicians 1

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

• Tihomir B Mihaylov, MD

  • Family Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1598985186

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1669168563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S ROCHESTER RD # 1104",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52188 VAN DYKE AVE STE 201A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163569",
            "telephone_number": "586-991-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HOSPICE CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "RABIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-785-0622"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Shelby Township, MI
• Community Based Hospice Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.