Active NPI
Melody Care Hospice
- Community Based Hospice Care Agency
- Upland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- MELODY CARE HOSPICE
- Practice address
- 876 N Mountain Ave Ste 102
Upland, CA 91786-4166 - Phone
- (909) 931-9277
- NPI assigned
- Mar 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Archibon Lamaria
- Title
- President
- Phone
- (909) 931-9277
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
876 N Mountain Ave Ste 102
Upland, CA 91786-4166
Mailing address
876 N Mountain Ave Ste 102
Upland, CA 91786-4166
Phone (909) 931-9277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220103001748 | CA | Part A Provider - Hospice | 4385035245 | Practice locations: Upland, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1730764531. Details of each certification follow.
Hospice certification: CCN B31731
- Legal name
- MELODY CARE HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 13, 2022
- Last certification
- Apr 13, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jan 31, 2021 in CA
- Enrollment address
- 600 N Mountain Ave
Ste A106
Upland, CA 91786-4359
Care Compare: Hospice
Medicare Care Compare- Listed as
- Cypress Hospice
- Certified
- Apr 13, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2322995 | Melody Care Hospice | Certificate of waiver | Apr 29, 2027 |
National Provider Directory
National Provider DirectoryLocations
876 N Mountain Ave
Ste 102
Upland, CA 91786
Phone (909) 931-9277
600 N Mountain Ave
Ste A106
Upland, CA 91786
Phone (323) 388-3510
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Donata Martinez Lamaria | 5% Or Greater Direct Ownership Interest | Jan 21, 2021 | 100% |
| Corporate Officer | Jan 21, 2021 | 100% | |
| Corporate Director | Jan 21, 2021 | 100% | |
| W-2 Managing Employee | Jan 21, 2021 | 100% | |
| Archibon M Lamaria | Corporate Officer | Jan 21, 2021 | |
| W-2 Managing Employee | Jan 21, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712448000000",
"number": "1730764531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "876 N MOUNTAIN AVE STE 102",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864166",
"telephone_number": "909-931-9277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "876 N MOUNTAIN AVE STE 102",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864166",
"telephone_number": "909-931-9277"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MELODY CARE HOSPICE",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-12",
"last_updated": "2024-04-07",
"certification_date": "2024-04-07",
"status": "A",
"authorized_official_last_name": "LAMARIA",
"authorized_official_first_name": "ARCHIBON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "909-931-9277"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.