Panacea Group, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PANACEA GROUP, INC.

Practice address

3786 La Crescenta Ave
Suite 105
Glendale, CA 91208-1055

Phone

(818) 243-0010

Fax

(818) 243-0011

NPI assigned

May 30, 2010

Last updated

Mar 2, 2016By 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

Simon Karimian

Title

Ceo

Phone

(818) 243-0010

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 1669791646. Details of each certification follow.

• CCN 059437 Home health agency · Active · Details

Home health agency certification: CCN 059437

Legal name

PANACEA GROUP INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 19, 2012

Last certification

May 17, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Sep 25, 2009 in CA

Enrollment address

3786 La Crescenta Ave
Ste 105
Glendale, CA 91208-1009
HHA Branch

Listed as

Panacea Group, IncCCN 059437 · All quality measures

Ownership

Proprietary

Certified

May 19, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Tax ID family

Panacea Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Panacea Group, Inc.

  • Home Health Agency
  • Los Angeles, CA
  • NPI 1780926550
  NPD tax ID

Locations

All disclosed owners & managing parties 2

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.

• Raffi R Minasian, MD

  • Nephrology Physician
  • Glendale, CA
  • NPI 1306860465

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1275177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1669791646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3786 LA CRESCENTA AVE",
            "address_2": "SUITE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081055",
            "telephone_number": "818-243-0010",
            "fax_number": "818-243-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3786 LA CRESCENTA AVE",
            "address_2": "SUITE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081055",
            "telephone_number": "818-243-0010",
            "fax_number": "818-243-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-30",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "KARIMIAN",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-243-0010"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Helga Pangilinan
• Andrew Panosian

• Home Health Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.