Organization Active NPI

Vista Community Hospice, Inc.

Doing business as Compassionate Care Hospice

  • Community Based Hospice Care Agency
  • San Diego, CA
National Provider Identifier
1679173736
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VISTA COMMUNITY HOSPICE, INC.
Doing business as
Compassionate Care Hospice
Practice address
3636 Camino del Rio N Ste 245
San Diego, CA 92108-1702
Phone
(760) 536-5442
Fax
(760) 546-2391
NPI assigned
Oct 28, 2020
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Lamberto Hernadez Valiente Jr., RN
Title
Owner
Phone
(760) 536-5442

Specialties & licenses 1

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

Addresses

Primary practice location

3636 Camino del Rio N Ste 245
San Diego, CA 92108-1702

Mailing address

3636 Camino del Rio N Ste 245
San Diego, CA 92108-1702
Phone (760) 536-5442

Other names 1

  • Compassionate Care Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201207000253 CA Part A Provider - Hospice 8123439619 Practice locations: Vista, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679173736. Details of each certification follow.

Hospice certification: CCN B31638

Legal name
VISTA COMMUNITY HOSPICE INC
Doing business as
COMPASSIONATE CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 1, 2021
Last certification
Dec 1, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 26, 2019 in CA
Enrollment address
830 E Vista Way
Ste 111
Vista, CA 92084-5216

Care Compare: Hospice

Medicare Care Compare
Listed as
Vista Community Hospice IncCCN B31638 · All quality measures
Certified
Dec 1, 2021
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
05D2288523Vista Community Hospice, Inc3636 Camino del Rio N Ste 245, San Diego, CA 92108Certificate of waiverAug 24, 2027

National Provider Directory

National Provider Directory

Locations

3636 Camino del Rio N
Ste 245
San Diego, CA 92108
Phone (760) 536-5442

830 E Vista Way
Ste 111
Vista, CA 92084
Phone (760) 536-5442

Ownership & related parties

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.

NameRoleSinceShare
Luzviminda J Bergado Individual Corporate DirectorDirector of Patient Care Services Oct 16, 2023 100%
Lamberto H Valiente Individual 5% Or Greater Direct Ownership Interest Jul 5, 2022 100%
Corporate OfficerCeo/Cfo/Secretary Jul 5, 2022 100%
Corporate DirectorCeo/Cfo/Secretary Jul 5, 2022 100%
W-2 Managing EmployeeCeo/Cfo/Secretary Jul 5, 2022 100%
Operational/Managerial ControlCeo/Cfo/Secretary Jul 5, 2022 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1679173736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 CAMINO DEL RIO N STE 245",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081702",
            "telephone_number": "760-536-5442",
            "fax_number": "760-546-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 CAMINO DEL RIO N STE 245",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081702",
            "telephone_number": "760-536-5442",
            "fax_number": "760-546-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA COMMUNITY HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "VALIENTE",
        "authorized_official_first_name": "LAMBERTO",
        "authorized_official_middle_name": "HERNADEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-536-5442",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassionate Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.