Active NPI
Sherman Oaks Hospice Care Group Inc
- Community Based Hospice Care Agency
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 550002042
- Legal business name
- SHERMAN OAKS HOSPICE CARE GROUP INC
- Practice address
- 2141 W Orangewood Ave
Orange, CA 92868-1955 - Phone
- (714) 733-1333
- Fax
- (714) 733-1334
- NPI assigned
- Nov 3, 2011
- 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
- Shahab Zahed, MD
- Title
- Ceo
- Phone
- (714) 733-1333
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 550002042 | CA | Primary |
Addresses
Primary practice location
2141 W Orangewood Ave
Orange, CA 92868-1955
Mailing address
2141 W Orangewood Ave
Orange, CA 92868-1955
Phone (714) 733-1333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5019540 | Medicaid | CA |
Other names 1
- Graceland Hospice Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
Hospice certification: CCN 551748
- Legal name
- SHERMAN OAKS HOSPICE CARE GROUP INC
- Doing business as
- GRACELAND HOSPICE CARE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 18, 2013
- Last certification
- May 3, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jul 14, 2011 in CA
- Enrollment address
- 2141 W Orangewood Ave
Ste a
Orange, CA 92868-1955
Care Compare: Hospice
Medicare Care Compare- Listed as
- Graceland Hospice Care
- Ownership
- For-Profit
- Certified
- Jul 18, 2013
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
6481 Orangethorpe Ave
Ste 27
Buena Park, CA 90620
Phone (562) 448-8721
2141 W Orangewood Ave
Ste A
Orange, CA 92868
1855 W Katella Ave
Ste 255
Orange, CA 92867
Phone (714) 733-1333
Ownership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Barbara J Davis | Corporate Director | May 15, 2015 | |
| W-2 Managing Employee | Jun 30, 2022 | ||
| Fransis Guerrero | W-2 Managing Employee | Sep 17, 2019 | |
| Debra Felix | W-2 Managing Employee | Aug 22, 2022 | |
| Premier Physicians Associates, LLC | 5% Or Greater Direct Ownership Interest | Apr 8, 2015 | 100% |
| Owrang Dastmalchi | 5% Or Greater Indirect Ownership Interest | Apr 8, 2015 | |
| Shahab Zahed | Contracted Managing Employee | Oct 31, 2022 | |
| 5% Or Greater Indirect Ownership Interest | Apr 8, 2015 | ||
| Operational/Managerial Control | Aug 15, 2021 |
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Laguna Hills, CA
- NPI 1922049188
5% Or Greater Indirect Ownership Interest
-
- Internal Medicine Physician
- Irvine, CA
- NPI 1942425079
Corporate Director, W-2 Managing Employee
-
- Internal Medicine Physician
- Orange, CA
- NPI 1780690131
5% Or Greater Indirect Ownership Interest, Contracted Managing Employee, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Orange, CA
- NPI 1780690131
Affiliated clinicians 9
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": "1320278400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1723420800000",
"number": "1790061828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2141 W ORANGEWOOD AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928681955",
"telephone_number": "714-733-1333",
"fax_number": "714-733-1334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2141 W ORANGEWOOD AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928681955",
"telephone_number": "714-733-1333",
"fax_number": "714-733-1334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHERMAN OAKS HOSPICE CARE GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-11-03",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A",
"authorized_official_last_name": "ZAHED",
"authorized_official_first_name": "SHAHAB",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "714-733-1333",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CA",
"license": "550002042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5019540",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Graceland Hospice Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.