United Hearts Hospice Health Services Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

UNITED HEARTS HOSPICE HEALTH SERVICES INC

Practice address

2139 Tapo St
Suite 219
Simi Valley, CA 93063-3478

Phone

(805) 791-3579

Fax

(805) 791-3179

NPI assigned

Oct 8, 2015

Last updated

Oct 8, 2015By 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

Mrs. Rima Abdurashidova, RN

Title

Ceo

Phone

(805) 791-3579

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 1710358320. Details of each certification follow.

• CCN 921730 Hospice · Active · Details

Hospice certification: CCN 921730

Legal name

UNITED HEARTS HOSPICE HEALTH SERVICES INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 18, 2017

Last certification

Jun 8, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Aug 3, 2015 in CA

Enrollment address

2139 Tapo St 219
Simi Valley, CA 93063-3477

Listed as

United Hearts Hospice Health ServicesCCN 921730 · All quality measures

Ownership

For-Profit

Certified

Sep 18, 2017

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 3

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.

• Ricardo Antonio Tan, MD

  • Allergy Physician
  • Los Angeles, CA
  • NPI 1255353629

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Ricardo Antonio Tan, MD

  • Allergy Physician
  • Los Angeles, CA
  • NPI 1255353629

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1710358320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 TAPO ST",
            "address_2": "SUITE 219",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633478",
            "telephone_number": "805-791-3579",
            "fax_number": "805-791-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 TAPO ST",
            "address_2": "SUITE 219",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633478",
            "telephone_number": "805-791-3579",
            "fax_number": "805-791-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEARTS HOSPICE HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "ABDURASHIDOVA",
        "authorized_official_first_name": "RIMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-791-3579",
        "authorized_official_name_prefix": "Mrs.",
        "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 Simi Valley, CA
• Providers in Simi Valley, 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, 2015; 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.