Saint Luka Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SAINT LUKA HOSPICE, INC.

Practice address

517 E Wilson Ave Ste 103B
Glendale, CA 91206-4376

Phone

(818) 960-7272

Fax

(818) 960-7277

NPI assigned

Nov 13, 2018

Last updated

Nov 13, 2018By 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

Marina Zilfyan

Title

Cfo/Secretary

Phone

(818) 960-7272

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 1720557333. Details of each certification follow.

• CCN A11652 Hospice · Active · Details

Hospice certification: CCN A11652

Legal name

SAINT LUKA HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 28, 2020

Last certification

Sep 28, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 1, 2018 in CA

Enrollment address

14015 Van Ness Ave
Ste 6
Gardena, CA 90249-2937

Listed as

Saint Luka Hospice, IncCCN A11652 · All quality measures

Ownership

For-Profit

Certified

Sep 28, 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.

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1720557333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 E WILSON AVE STE 103B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064376",
            "telephone_number": "818-960-7272",
            "fax_number": "818-960-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E WILSON AVE STE 103B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064376",
            "telephone_number": "818-960-7272",
            "fax_number": "818-960-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUKA HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "ZILFYAN",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "CFO/SECRETARY",
        "authorized_official_telephone_number": "818-960-7272"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 Nov 13, 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.