Evolve Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EVOLVE HOSPICE, INC.

Practice address

18305 Sherman Way # 23
Reseda, CA 91335-4425

Phone

(747) 336-3193

NPI assigned

Sep 25, 2020

Organization subpart

No

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

Authorized official

Name

Sahak Keshishyan

Title

Ceo

Phone

(747) 336-3193

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B51524

Legal name

EVOLVE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 9, 2022

Last certification

Oct 20, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 8, 2020 in CA

Enrollment address

18305 Sherman Way
Ste 23
Reseda, CA 91335-4425

Listed as

Evolve Hospice, IncCCN B51524

Certified

Nov 9, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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.

Affiliated clinicians 1

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

• Maria Lourdes Castanos De Leon, M.D.

  • General Practice Physician
  • South Gate, CA
  • NPI 1285775437

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1760099501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18305 SHERMAN WAY # 23",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18305 SHERMAN WAY # 23",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354425",
            "telephone_number": "747-336-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "KESHISHYAN",
        "authorized_official_first_name": "SAHAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-336-3193"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Margarita Fajardo

• All providers in Reseda, CA
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.