Blue Sky Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BLUE SKY HOSPICE INC

Doing business as

Blue Sky Hospice Inc

Practice address

8035 E Brown Rd Ste 200
Mesa, AZ 85207-3901

Phone

(480) 389-2482

NPI assigned

Jun 5, 2019

Organization subpart

No

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

Authorized official

Name

Patric Brady Hess

Title

Manager

Phone

(801) 771-9099

Specialties & licenses 1

Addresses

Other names 1

• BLUE SKY HOSPICE INC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811555683. Details of each certification follow.

• CCN 031701 Hospice · Active · Details

Hospice certification: CCN 031701

Legal name

BLUE SKY HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 18, 2019

Last certification

Dec 18, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 28, 2019 in AZ

Enrollment address

8035 E Brown Rd
# 200
Mesa, AZ 85207-3901

Listed as

Blue Sky Hospice, IncCCN 031701 · All quality measures

Ownership

For-Profit

Certified

Dec 18, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 11

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.

• Waqas Ahmad Qamar, MD

  • Hospitalist Physician
  • Mesa, AZ
  • NPI 1447517503

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Waqas Ahmad Qamar, MD

  • Hospitalist Physician
  • Mesa, AZ
  • NPI 1447517503

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1811555683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 E SHEA BLVD STE 200-205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283345",
            "telephone_number": "623-401-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 E BROWN RD STE 200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073901",
            "telephone_number": "480-389-2482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 E Shea Blvd Ste 200-205",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850283345",
            "country_code": "US",
            "telephone_number": "623-401-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE SKY HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "PATRIC",
        "authorized_official_middle_name": "BRADY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-771-9099"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE SKY HOSPICE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLUE SKY HOSPICE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.