Organization Active NPI

Angel Care Plus Hospice, LLC

Doing business as Angel Care Hospice

  • Community Based Hospice Care Agency
  • Richardson, TX
National Provider Identifier
1720376650
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ANGEL CARE PLUS HOSPICE, LLC
Doing business as
Angel Care Hospice
Practice address
1350 E Arapaho Rd Ste 207
Richardson, TX 75081-2453
Phone
(972) 301-5600
Fax
(972) 301-5606
NPI assigned
Jul 12, 2011
Last updated
Aug 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Mr. Mathew Korah
Title
Vice President
Phone
(972) 301-5600

Specialties & licenses 1

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

Addresses

Primary practice location

1350 E Arapaho Rd Ste 207
Richardson, TX 75081-2453

Mailing address

1350 E Arapaho Rd Ste 207
Richardson, TX 75081-2453
Phone (972) 301-5600

Other names 1

  • Angel Care Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120806000869 TX Part A Provider - Hospice 1951557008 Practice locations: Richardson, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720376650. Details of each certification follow.

Hospice certification: CCN 671675

Legal name
ANGEL CARE PLUS HOSPICE LLC
Doing business as
ANGEL CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 17, 2011
Last certification
Jun 18, 2021
Ownership / control type
Other
Organization structure
LLCProprietary
Enrollment address
1350 E Arapaho Rd
Ste 207
Richardson, TX 75081-2453

Care Compare: Hospice

Medicare Care Compare
Listed as
Angel Care HospiceCCN 671675 · All quality measures
Ownership
For-Profit
Certified
Mar 17, 2011
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2002308Angel Care Plus Hospice, LLC1350 E Arapaho Rd Suite 207, Richardson, TX 75081Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Dee L Martinez Individual 5% Or Greater Direct Ownership Interest Apr 1, 2012 10%
Elsy J Benjamin Individual W-2 Managing EmployeeAlternate Supervising Nurse Jan 25, 2021
Mathew Korah Individual 5% Or Greater Direct Ownership Interest Apr 1, 2012 15%
Corporate Director Apr 1, 2012
W-2 Managing Employee Apr 1, 2012
Patience U Uche Individual W-2 Managing EmployeeSsupervising Nurse Jun 16, 2020
Suma C Jacob Individual 5% Or Greater Direct Ownership Interest Apr 1, 2017 75%
Corporate OfficerOwner President Jan 3, 2017
W-2 Managing Employee Jan 3, 2017
Syed M a Jamal Individual Contracted Managing EmployeeMD; Jan 1, 2023

Owners & managing parties with NPI records 3

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

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1720376650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E ARAPAHO RD STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812453",
            "telephone_number": "972-301-5600",
            "fax_number": "972-301-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E ARAPAHO RD STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812453",
            "telephone_number": "972-301-5600",
            "fax_number": "972-301-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL CARE PLUS HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "KORAH",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "972-301-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Angel Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.