Rose Garden Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ROSE GARDEN HOSPICE, INC.

Practice address

3171 Los Feliz Blvd Ste 311a
Los Angeles, CA 90039-1537

Phone

(310) 817-0972

NPI assigned

Dec 2, 2020

Last updated

Dec 7, 2020By 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

Susanna Ovsepyan

Title

Ceo

Phone

(310) 817-0972

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 1720683253. Details of each certification follow.

• CCN B41756 Hospice · Active · Details

Hospice certification: CCN B41756

Legal name

ROSE GARDEN HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 10, 2022

Last certification

Aug 10, 2022

Organization structure

CorporationProprietary

Incorporated

Nov 13, 2020 in CA

Enrollment address

3171 Los Feliz Blvd
Ste 311a
Los Angeles, CA 90039-1537

Listed as

Rose Garden Hospice, Inc.CCN B41756 · All quality measures

Certified

Aug 10, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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.

• Nicola Faris Azar, M.D.

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1922259787

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicola Faris Azar, M.D.

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1922259787
  NPD (past)

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1720683253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3171 LOS FELIZ BLVD STE 311A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391537",
            "telephone_number": "310-817-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3171 LOS FELIZ BLVD STE 311A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391537",
            "telephone_number": "310-817-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE GARDEN HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "OVSEPYAN",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-817-0972"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhitlaly Rosas
• Charles Rosasco
• Michael D. Rosberg, PHD
• Clanae Rosborough
• Rachael Roscoe
• Rose Medical Group
• Rose Moon Birth Services LLC
• Sheri Ann Rose-McCashin, LMFT
• Julia Rose-Ramo
• Abigail Maureen Rose, LCSW

• Community Based Hospice Care Agency in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 7, 2020; 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.