NPIMap

Organization Active NPI

Transitions Lifecare LLC

Doing business as Transitions Lifecare Hospice

  • Community Based Hospice Care Agency
  • Tulsa, OK
National Provider Identifier
1710228663
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
TRANSITIONS LIFECARE LLC
Doing business as
Transitions Lifecare Hospice
Practice address
1515 E 71St St
Suite 100
Tulsa, OK 74136-5046
Phone
(918) 551-6879
Fax
(918) 551-6890
NPI assigned
Mar 1, 2013
Last updated
Mar 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
Mr. Joshua Haven Brazeal
Title
Director of Business Operations
Phone
(918) 551-6879

Specialties & licenses 1

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

Addresses

Primary practice location

1515 E 71St St
Suite 100
Tulsa, OK 74136-5046

Mailing address

1515 E 71St St
Suite 100
Tulsa, OK 74136-5046
Phone (918) 551-6879

Other names 1

  • Transitions Lifecare Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140716000851 OK Part A Provider - Hospice 9133369820 Practice locations: Tulsa, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710228663. Details of each certification follow.

Hospice certification: CCN 371676

Legal name
TRANSITIONS LIFECARE LLC
Doing business as
TRANSITIONS LIFECARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 20, 2006
Last certification
Jul 26, 2022
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Mar 1, 2013 in OK
Enrollment address
6310 E 102ND St
Tulsa, OK 74137-7061

Care Compare: Hospice

Medicare Care Compare
Listed as
Transitions Lifecare HospiceCCN 371676 · All quality measures
Ownership
Other
Certified
Nov 20, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Transitions Lifecare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1515 E 71st St
Ste 100
Tulsa, OK 74136
Phone (918) 551-6879

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Joshua Brazeal Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 50%
Corporate OfficerBoard Member Apr 30, 2014 50%
W-2 Managing EmployeeDir of Operations,Board Member Apr 30, 2014 50%
David S Brazeal Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 50%
Corporate OfficerBoard Member Apr 30, 2014 50%
W-2 Managing EmployeeDir of Business Development, Boa Apr 30, 2014 50%
Edward E Rylander Individual Contracted Managing EmployeeMD; Jan 1, 2014

Owners & managing parties with NPI records 1

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1710228663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 71ST ST",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365046",
            "telephone_number": "918-551-6879",
            "fax_number": "918-551-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E 71ST ST",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365046",
            "telephone_number": "918-551-6879",
            "fax_number": "918-551-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSITIONS LIFECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "BRAZEAL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "HAVEN",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "918-551-6879",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Transitions Lifecare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.