Organization Active NPI

US Medtrade Hospice, Inc.

  • Community Based Hospice Care Agency
  • Van Nuys, CA
National Provider Identifier
1790068765
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
US MEDTRADE HOSPICE, INC.
Practice address
7040 Hayvenhurst Ave
Suite 203
Van Nuys, CA 91406-3801
Phone
(818) 761-2721
NPI assigned
Sep 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Andrew Stepansky
Title
Ceo
Phone
(818) 761-2721

Specialties & licenses 1

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

Addresses

Primary practice location

7040 Hayvenhurst Ave
Suite 203
Van Nuys, CA 91406-3801

Mailing address

7040 Hayvenhurst Ave
Suite 203
Van Nuys, CA 91406-3801
Phone (818) 761-2721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120622000538 CA Part A Provider - Hospice 6204091358 Practice locations: Van Nuys, CA

Hospice certification: CCN 551739

Legal name
US MEDTRADE HOSPICE, INC.
Doing business as
US MEDTRADE HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 23, 2013
Last certification
Sep 6, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Enrollment address
16159 Cohasset St
Ste 201
Van Nuys, CA 91406-2908

Care Compare: Hospice

Medicare Care Compare
Listed as
Usm HospiceCCN 551739
Ownership
For-Profit
Certified
Jul 23, 2013
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

7040 Hayvenhurst Ave
Ste 201
Van Nuys, CA 91406
Phone (818) 761-2721

16159 Cohasset St
Ste 201
Van Nuys, CA 91406
Phone (818) 761-2721

7040 Hayvenhurst Ave
Ste 203
Van Nuys, CA 91406
Phone (818) 761-2721

Ownership & related parties

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.

NameRoleSinceShare
Igor Gary Shlifer Individual W-2 Managing EmployeeMD; Oct 20, 2020
Anna Barsegyan Individual W-2 Managing Employee Jun 28, 2012
Andrew Stepansky Individual 5% Or Greater Direct Ownership Interest May 1, 2015 100%
Corporate OfficerCeo May 1, 2015 100%
Corporate DirectorBoard of Director Mar 28, 2014 50%
W-2 Managing EmployeeAdministrator May 1, 2015 100%

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1790068765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 HAYVENHURST AVE",
            "address_2": "SUITE 203",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063801",
            "telephone_number": "818-761-2721",
            "fax_number": "818-761-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 HAYVENHURST AVE",
            "address_2": "SUITE 203",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063801",
            "telephone_number": "818-761-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US MEDTRADE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "STEPANSKY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-761-2721"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.