NPIMap

Organization Active NPI

Compassionate Care Hospice Central California LLC

  • Community Based Hospice Care Agency
  • Fresno, CA
National Provider Identifier
1740741529
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC
Doing business as
Compassionate Care Hospice Central California LLC
Practice address
7545 N del Mar Ave Ste 204
Fresno, CA 93711-5847
Phone
(559) 432-2003
Fax
(559) 705-1910
NPI assigned
Mar 26, 2019
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Mrs. Cristiane Kasdorf Vega
Title
Administrator
Phone
(559) 432-2003

Specialties & licenses 1

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

Addresses

Primary practice location

7545 N del Mar Ave Ste 204
Fresno, CA 93711-5847

Mailing address

7545 N del Mar Ave Ste 204
Fresno, CA 93711-5847
Phone (559) 432-2003

Other names 1

  • COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190912003135 CA Part A Provider - Hospice 0143559302 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740741529. Details of each certification follow.

Hospice certification: CCN A01798

Legal name
COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 4, 2020
Last certification
Aug 4, 2020
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Aug 3, 2018 in CA
Enrollment address
7545 N del Mar Ave
Ste 204
Fresno, CA 93711-5847

Care Compare: Hospice

Medicare Care Compare
Listed as
Compassionate Care Hospice Central California, LLCCCN A01798 · All quality measures
Ownership
Other
Certified
Aug 4, 2020
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
05D2172308Compassionate Care Hospice7545 North del Mar Ave Ste 204, Fresno, CA 93711Certificate of waiverSep 18, 2027

National Provider Directory

National Provider Directory

Locations

7545 N Del Mar Ave
Ste 204
Fresno, CA 93711
Phone (559) 432-2003

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Deborah Favila Individual Corporate DirectorAlternate Medical Director Nov 25, 2019
Ajit Singh Jhujj Individual Corporate DirectorAlternate DPCS Apr 12, 2024
W-2 Managing EmployeeAlternate DPCS Apr 11, 2022
Nicholas Sanchez Individual 5% Or Greater Direct Ownership InterestCoo/Owner Aug 3, 2018 20%
Corporate Officer Aug 3, 2018
Kuljeet Kaleka Individual 5% Or Greater Direct Ownership Interest Aug 3, 2018 40%
Brent Alan Wilson Individual Contracted Managing EmployeeMD; Jul 1, 2019
Shawnvir Kaleka Individual 5% Or Greater Direct Ownership InterestCeo/Owner Aug 3, 2018 40%
Operational/Managerial Control Aug 3, 2018
Steven Sr Silva Individual Corporate DirectorDirector of Patient Care Services Mar 1, 2021
W-2 Managing Employee Mar 1, 2021
Cristiane Kasdorf Vega Individual W-2 Managing EmployeeAdministrator Nov 25, 2019
Operational/Managerial ControlAdministrator Nov 25, 2019

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1740741529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 N DEL MAR AVE STE 204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115847",
            "telephone_number": "559-432-2003",
            "fax_number": "559-899-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 N DEL MAR AVE STE 204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115847",
            "telephone_number": "559-432-2003",
            "fax_number": "559-705-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "KASDORF VEGA",
        "authorized_official_first_name": "CRISTIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-432-2003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.