Orange County Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

550002206 Issued in CA

Legal business name

ORANGE COUNTY HOSPICE, LLC

Practice address

13522 Newport Ave
Suite 200
Tustin, CA 92780-3707

Phone

(714) 838-1542

NPI assigned

Jan 26, 2011

Organization subpart

No

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

Authorized official

Name

Jennifer Lyn Kennedy

Title

Ceo/Administrator

Phone

(714) 838-1542

Specialties & licenses 1

Addresses

Other names 1

• OC Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551741

Legal name

ORANGE COUNTY HOSPICE, LLC

Doing business as

OC HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 20, 2013

Last certification

Jun 6, 2019

Ownership / control type

Proprietary - Partnership

Organization structure

LLCProprietary

Incorporated

Jan 1, 2011 in CA

Enrollment address

13522 Newport Ave
Ste 200
Tustin, CA 92780-3707

Listed as

Oc HospiceCCN 551741

Ownership

For-Profit

Certified

Aug 20, 2013

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 5

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.

• George Moran Jr., MD

  • Internal Medicine Physician
  • Montclair, CA
  • NPI 1639673635

  Contracted Managing Employee, W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• George Moran Jr., MD

  • Internal Medicine Physician
  • Montclair, CA
  • NPI 1639673635

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1780989509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13522 NEWPORT AVE",
            "address_2": "SUITE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803707",
            "telephone_number": "714-838-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13522 NEWPORT AVE",
            "address_2": "SUITE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803707",
            "telephone_number": "714-838-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "714-838-1542"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "550002206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Tustin, CA
• Providers in Tustin, 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 Jan 7, 2014; 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.