Active NPI
Applied Palliative and Hospice Services, Inc.
- Community Based Hospice Care Agency
- Rancho Cordova, CA
National Provider Identifier
1679954408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.
- Practice address
- 2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538 - Phone
- (916) 638-8719
- Fax
- (844) 273-1326
- NPI assigned
- Jun 17, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Shirley Villanueva Dizon
- Title
- Ceo
- Phone
- (916) 638-8719
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538
Mailing address
2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538
Phone (916) 638-8719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150825003752 | CA | Part A Provider - Hospice | 0244546083 | Practice locations: Rancho Cordova, CA |
Hospice certification: CCN 921535
- Legal name
- APPLIED PALLIATIVE AND HOSPICE SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 19, 2016
- Last certification
- Aug 23, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jul 15, 2015 in CA
- Enrollment address
- 2865 Sunrise Blvd 103
Rancho Cordova, CA 95742-6104
Care Compare: Hospice
Medicare Care Compare- Listed as
- Applied Palliative and Hospice Services, Inc
- Ownership
- For-Profit
- Certified
- Oct 19, 2016
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
2865 Sunrise Blvd
Ste 103
Rancho Cordova, CA 95742
Phone (916) 638-8719
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Edgardo M Alon | Corporate Director | Jul 11, 2018 | 100% |
| Operational/Managerial Control | Jul 11, 2018 | 100% | |
| Shirley V Dizon | 5% Or Greater Direct Ownership Interest | Jun 15, 2015 | 100% |
| Corporate Officer | Jun 15, 2015 | 100% | |
| Corporate Director | Jun 15, 2015 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1434499200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676851200000",
"number": "1679954408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2865 SUNRISE BLVD",
"address_2": "SUITE 103",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957426538",
"telephone_number": "916-638-8719",
"fax_number": "844-273-1326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 SUNRISE BLVD",
"address_2": "SUITE 103",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957426538",
"telephone_number": "916-638-8719",
"fax_number": "844-273-1326"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-17",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A",
"authorized_official_last_name": "DIZON",
"authorized_official_first_name": "SHIRLEY",
"authorized_official_middle_name": "VILLANUEVA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "916-638-8719",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.