Luna Vista Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LUNA VISTA HOSPICE LLC

Practice address

2116 Vista Oeste NW
# 1B
Albuquerque, NM 87120-4340

Phone

(505) 977-1165

Fax

(505) 247-6811

NPI assigned

Aug 12, 2019

Last updated

Aug 24, 2021By 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

Jamie Gonzalez

Title

Administrator /Owner

Phone

(505) 977-3131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720634165. Details of each certification follow.

• CCN 321578 Hospice · Active · Details

Hospice certification: CCN 321578

Legal name

LUNA VISTA HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 24, 2019

Last certification

Dec 24, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jun 4, 2019 in NM

Enrollment address

2116 Vista Oeste NW
Ste 1B
Albuquerque, NM 87120-4340

Listed as

Luna Vista Hospice, LLCCCN 321578 · All quality measures

Ownership

For-Profit

Certified

Dec 24, 2019

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.

• Robin David Knight, D.O.

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1073715496

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 2

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

• Camila S Jaramillo, MD

  • Internal Medicine Physician
  • Los Ranchos, NM
  • NPI 1790879187

  Hospice

  Care Compare affiliation
• Robin David Knight, D.O.

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1073715496

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1720634165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 VISTA OESTE NW",
            "address_2": "# 1B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204340",
            "telephone_number": "505-977-1165",
            "fax_number": "505-247-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 VISTA OESTE NW",
            "address_2": "# 1B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204340",
            "telephone_number": "505-977-1165",
            "fax_number": "505-247-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA VISTA HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "ADMINISTRATOR /OWNER",
        "authorized_official_telephone_number": "505-977-3131"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luminaria ABA Therapy LLC
• Luna del Valle Healthcare Services (Luna Del Valle Hospice)
• Clara Luna Fernandez, RBT
• Paulina Del Carmen Luna Iniguez, M.D.
• Luna Vista Home Healthcare LLC
• Luna X2 LLC
• Luna Y Sol Midwifery, Servicios de Parteria
• Lizbeth Sonia Luna-Wimberley, MD
• Alice M Luna, MD
• Amber Luna, PA-C

• Community Based Hospice Care Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community Based Hospice Care Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.