Casavina Foundation Corp

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

070000265 Issued in CA

Legal business name

CASAVINA FOUNDATION CORP

Practice address

2501 Alvin Ave
San Jose, CA 95121-1660

Phone

(408) 238-9751

Fax

(408) 238-3905

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Josh Hedger

Title

Administrator

Phone

(408) 238-9751

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Skilled nursing facility certification: CCN 555487

Legal name

CASAVINA FOUNDATION CORP

Doing business as

MISSION DE LA CASA

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 17, 1991

Last certification

Jun 27, 2024

Beds

163

Ownership / control type

Individual

Organization structure

CorporationProprietary

Incorporated

Oct 27, 1999 in CA

Enrollment address

2501 Alvin Ave
San Jose, CA 95121-1660

Nursing home name

MISSION DE LA CASA

Listed as

Mission de la CasaCCN 555487

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Dec 17, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

163153.8 residents per day on average

Penalties (3 years)

1Fines totaling $51,753

Processed by Care Compare on Aug 1, 2026.

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 22

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 3

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

• Ngai Xuan Nguyen, MD

  • Cardiovascular Disease Physician
  • San Jose, CA
  • NPI 1205883501

  5% Or Greater Direct Ownership Interest, Adp of the SNF, Corporate Director, Corporate Officer, Operational/Managerial Control

  CMS ownership
• Daniel Yung Tse, MD

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1437258027

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Surekha Santoshkumar Vetsa, M.D

  • Internal Medicine Physician
  • Sunnyvale, CA
  • NPI 1184650871

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

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

• Kyaw Min, M.D.

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1942604665

  Nursing home

  Care Compare affiliation
• Daniel Yung Tse, MD

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1437258027

  Nursing home

  Care Compare affiliation
• Surekha Santoshkumar Vetsa, M.D

  • Internal Medicine Physician
  • Sunnyvale, CA
  • NPI 1184650871

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1720032329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 ALVIN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211660",
            "telephone_number": "408-238-9751",
            "fax_number": "408-238-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 ALVIN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211660",
            "telephone_number": "408-238-9751",
            "fax_number": "408-238-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASAVINA FOUNDATION CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "HEDGER",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "408-238-9751"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "070000265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMCSUBHDY",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC554875",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Erin Carwana, M.S., L.C.G.C.
• Abigail Romaine Carzon
• Jacklyn Dawn Casab, DC
• Sarah Louise Casabonne, MS, RD
• Andrew Casaca, CCC-SLP
• Samuel Christian Fermin Casco
• Sol Ailen Caselles
• Joseph Casey, M.D.
• Shelby Casey
• Dennis Cashman

• All providers in San Jose, CA
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.