Direct Provider of Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

DIRECT PROVIDER OF HOSPICE INC

Practice address

487 Corona Mall
Corona, CA 92879-1419

Phone

(951) 393-0020

Fax

(951) 393-0958

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Sylvie Boal

Title

Compliance

Phone

(513) 930-0209

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A01766

Legal name

DIRECT PROVIDER OF 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

Incorporated

Sep 1, 2015 in CA

Enrollment address

487 Corona Mall
Corona, CA 92879-1419

Listed as

Direct Provider of Hospice Inc.CCN A01766

Ownership

For-Profit

Certified

Jan 17, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 5

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 4

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

• Mohamad Albouidani, MD

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1770670713

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Tameem Alhayya, MD

  • Nephrology Physician
  • Corona, CA
  • NPI 1649283557

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Cypress, CA
  • NPI 1770783896

  Contracted Managing Employee

  CMS ownership
• Louay Shawesh, MD

  • Internal Medicine Physician
  • Huntington Beach, CA
  • NPI 1891954210

  5% Or Greater Direct Ownership Interest

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mohamad Albouidani, MD

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1770670713

  Hospice

  Care Compare affiliation
• Tameem Alhayya, MD

  • Nephrology Physician
  • Corona, CA
  • NPI 1649283557

  Hospice

  Care Compare affiliation
• Farnoosh Yari, M.D.

  • Internal Medicine Physician
  • Mission Viejo, CA
  • NPI 1972164895

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1710346192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791419",
            "telephone_number": "951-393-0020",
            "fax_number": "951-393-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791419",
            "telephone_number": "951-393-0020",
            "fax_number": "951-393-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT PROVIDER OF HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "BOAL",
        "authorized_official_first_name": "SYLVIE",
        "authorized_official_title_or_position": "COMPLIANCE",
        "authorized_official_telephone_number": "513-930-0209",
        "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": []
}

• Dien Dinh, PHARMD
• Mary Dinsmore
• Mariela Diocares
• Dione the Doula LLC
• Iris Dionicio
• Aimee Dirkx, RDH
• Nicole Emily Distel
• Meghana Divi
• Katahna Aaliyah Chenelle Dixie
• Khaila Dixon

• Community Based Hospice Care Agency in Corona, CA
• Providers in Corona, 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 Oct 8, 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.