Universal Health Net

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

597438 Issued in CA

Legal business name

UNIVERSAL HEALTH NET

Practice address

500 N State College Blvd Ste 1100
Orange, CA 92868-1625

Phone

(949) 690-5224

NPI assigned

Mar 22, 2013

Last updated

Jun 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ameneh Abusafieh

Title

Owner/Admin

Phone

(949) 690-5224

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821330325. Details of each certification follow.

• CCN 921558 Hospice · Active · Details

Hospice certification: CCN 921558

Legal name

UNIVERSAL HEALTH NET

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 6, 2016

Last certification

Apr 11, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

500 N State College Blvd
Ste 1100
Orange, CA 92868-1625

Listed as

Universal Health NetCCN 921558 · All quality measures

Ownership

For-Profit

Certified

May 6, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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.

• Sidney Mitchell, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Watsonville, CA
  • NPI 1518027630

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sidney Mitchell, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Watsonville, CA
  • NPI 1518027630
  Medicare reassignment NPD

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1821330325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 S STATE COLLEGE BLVD STE 330",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928060189",
            "telephone_number": "949-609-9693",
            "fax_number": "714-786-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N STATE COLLEGE BLVD STE 1100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681625",
            "telephone_number": "949-690-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "ABUSAFIEH",
        "authorized_official_first_name": "AMENEH",
        "authorized_official_title_or_position": "OWNER/ADMIN",
        "authorized_official_telephone_number": "949-690-5224"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "597438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Univ Head & Neck Surgeon
• University California Irvine Medical Center
• University Head & Neck Surgeons
• University of California - Irvine Medical Center
• University of California at Irvine Medical Center
• University of California Irvine (Outpatient Pharmacy - UC Irvine Health)

• Community Based Hospice Care Agency in Orange, CA
• Providers in Orange, 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 Jun 6, 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.

Verify at the official NPI Registry.