Advantage Hospice Providers Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ADVANTAGE HOSPICE PROVIDERS INC

Practice address

1934 W 9TH St Unit B
Upland, CA 91786-5607

Phone

(909) 296-7903

Fax

(909) 543-0841

NPI assigned

Aug 29, 2013

Last updated

Jan 15, 2024By 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

Tithkangna Farmer

Title

Owner

Phone

(909) 296-7903

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 1699109306. Details of each certification follow.

• CCN 751556 Hospice · Active · Details

Hospice certification: CCN 751556

Legal name

ADVANTAGE HOSPICE PROVIDERS, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 28, 2014

Last certification

May 27, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Aug 5, 2013 in CA

Enrollment address

1934 W 9TH St
Unit B
Upland, CA 91786-5617

Listed as

Advantage Hospice Providers, IncCCN 751556 · All quality measures

Ownership

For-Profit

Certified

Jul 28, 2014

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

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.

Owners & managing parties with NPI records 1

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

• Ravindranath Vishnu Shahane, M.D.

  • Internal Medicine Physician
  • Rialto, CA
  • NPI 1457420903

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cindy Canlas Eslava, MPT

  • Physical Therapist
  • Baldwin Park, CA
  • NPI 1174728778
  NPD (past)

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1699109306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 W 9TH ST UNIT B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865607",
            "telephone_number": "909-296-9034",
            "fax_number": "909-543-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 W 9TH ST UNIT B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865607",
            "telephone_number": "909-296-7903",
            "fax_number": "909-543-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE HOSPICE PROVIDERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "TITHKANGNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-296-7903"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.