NPIMap

Organization Active NPI

Ampm Hospice, Inc.

  • Community Based Hospice Care Agency
  • Sherman Oaks, CA
National Provider Identifier
1700403086
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AMPM HOSPICE, INC.
Practice address
14542 Ventura Blvd Ste 202
Sherman Oaks, CA 91403-5520
Phone
(818) 809-2375
NPI assigned
Jul 2, 2020
Last updated
Jul 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Authorized official

Name
Anna Kojoyan Anna Kojoyan
Title
Ceo
Phone
(818) 809-2375

Specialties & licenses 1

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

Addresses

Primary practice location

14542 Ventura Blvd Ste 202
Sherman Oaks, CA 91403-5520

Mailing address

14542 Ventura Blvd Ste 202
Sherman Oaks, CA 91403-5520
Phone (818) 809-2375

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210526001588 CA Part A Provider - Hospice 6800295718 Practice locations: Sherman Oaks, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700403086. Details of each certification follow.

Hospice certification: CCN B21712

Legal name
AMPM HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 23, 2021
Last certification
Aug 23, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
May 7, 2020 in CA
Enrollment address
14542 Ventura Blvd
Ste 202
Sherman Oaks, CA 91403-5520

Care Compare: Hospice

Medicare Care Compare
Listed as
Ampm Hospice, Inc.CCN B21712 · All quality measures
Ownership
For-Profit
Certified
Aug 23, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

14542 Ventura Blvd
Ste 202
Sherman Oaks, CA 91403
Phone (818) 809-2375

Ownership & related parties

All disclosed owners & managing parties 45

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

NameRoleSinceShare
Daniel P Hilton Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Corporate DirectorBoard Member May 1, 2023 4%
Jessica Preciado Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Salim Harianawala Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Rosalinda Arellano Individual 5% Or Greater Direct Ownership Interest May 1, 2023 1%
Griselda Duarte Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Chris Lusiani Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Michael Gonzalez Individual 5% Or Greater Direct Ownership Interest May 1, 2023 3%
Corporate DirectorBoard Member May 1, 2023 3%
Jose Toscano Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Noemi Gomez Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Sameer Ohri Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Ajay G Meka Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Leticia Hernandez Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Robby Ayoub Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Maria Guerrero Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Rohit Hemant Godbole Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Corporate DirectorBoard Member May 1, 2023 2%
Cerasela Maldovan Individual W-2 Managing EmployeeDirector of Patient Care Service Apr 1, 2022
Maria Melena Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Corporate DirectorBoard Member May 1, 2023
Blanca Sandoval Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.25%
Nilesh Mehta Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Corporate OfficerCfo May 1, 2023 2%
Corporate DirectorBoard Member May 1, 2023 2%
W-2 Managing EmployeeCfo May 1, 2023 2%
Anel Macias Individual 5% Or Greater Direct Ownership Interest May 1, 2023 1%
Corporate OfficerCeo May 1, 2023 1%
Jie Hu Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Omar Bojorquez Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Christopher E Salem Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Vannarith So Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Angelica Gonzalez Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Anna Roshan Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Patricia Ahoia Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Corporate DirectorSecretary May 1, 2023 4%
Jason M Fletcher Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Peyman Salimi-Tari Individual 5% Or Greater Direct Ownership Interest May 1, 2023 3%
Gimha S Gunawardana Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Gabriela Saldana Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.25%
Moran Hilton Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Armando Huerta Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Haresh S Jhangiani Individual 5% Or Greater Direct Ownership Interest May 1, 2023 3%
W-2 Managing EmployeeMD; Mar 1, 2022 3%
Visal Nga Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Charles Nguyen Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4%
Corporate DirectorBoard Member May 1, 2023 4%
Meena K Meka Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 3.5%
Corporate DirectorBoard Member May 1, 2023 3.5%
Carmencita Cordero Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 1%
W-2 Managing EmployeeAd; May 1, 2023 1%
Lipi Begum Individual 5% Or Greater Direct Ownership Interest May 1, 2023 1%
Stacy Marlin Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%
Don Arthur Estuita Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Martha Navarrete Individual 5% Or Greater Direct Ownership Interest May 1, 2023 0.5%
Lizbeth Mendoza Individual 5% Or Greater Direct Ownership Interest0.5 May 1, 2023
Barry R Marfleet Individual 5% Or Greater Direct Ownership Interest May 1, 2023 1%
Pete Blasi Individual 5% Or Greater Direct Ownership Interest May 1, 2023 2%

Owners & managing parties with NPI records 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1700403086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14542 VENTURA BLVD STE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035520",
            "telephone_number": "818-809-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14542 VENTURA BLVD STE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035520",
            "telephone_number": "818-809-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPM HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "ANNA KOJOYAN",
        "authorized_official_first_name": "ANNA KOJOYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-809-2375"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.