Procare Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PROCARE HOSPICE, INC.

Practice address

14852 Ventura Blvd Ste 201
Sherman Oaks, CA 91403-5946

Phone

(818) 660-2931

Fax

(818) 660-2269

NPI assigned

Dec 17, 2018

Organization subpart

No

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

Authorized official

Name

Laura D Bautista, RN

Title

Cfo

Phone

(818) 660-2931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A01719

Legal name

PROCARE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 17, 2020

Last certification

Jan 17, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

3089 N Lima St
Ste 108
Burbank, CA 91504-2013

Listed as

Procare Hospice, IncCCN A01719

Ownership

For-Profit

Certified

Jan 17, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

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

• Raymond J Dorio, M.D.

  • General Practice Physician
  • Newhall, CA
  • NPI 1205984739

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1689146532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14852 VENTURA BLVD STE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035946",
            "telephone_number": "818-660-2931",
            "fax_number": "818-660-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14852 VENTURA BLVD STE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035946",
            "telephone_number": "818-660-2931",
            "fax_number": "818-660-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-660-2931",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.