Active NPI
Loyalty Hospice Services, Inc.
- Community Based Hospice Care Agency
- Anaheim, CA
National Provider Identifier
1821553553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- LOYALTY HOSPICE SERVICES, INC.
- Practice address
- 1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347 - Phone
- (657) 208-1813
- Fax
- (714) 333-4638
- NPI assigned
- Feb 6, 2019
- 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
- Procopio T Misa
- Title
- Authorized Official
- Phone
- (657) 208-1813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347
Mailing address
1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347
Phone (657) 208-1813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C4238324 | Other | CA | SECRETARY OF STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200327002937 | CA | Part A Provider - Hospice | 9436588357 | Practice locations: Anaheim, CA |
Hospice certification: CCN B41646
- Legal name
- LOYALTY HOSPICE SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 1, 2022
- Last certification
- Aug 1, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Jan 28, 2019 in CA
- Enrollment address
- 1700 E Lincoln Ave
Ste 204
Anaheim, CA 92805-4347
Care Compare: Hospice
Medicare Care Compare- Listed as
- Loyalty Hospice Services, Inc
- Certified
- Aug 1, 2022
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
1700 E Lincoln Ave
Ste 204
Anaheim, CA 92805
Phone (657) 208-1813
Ownership & related parties
All disclosed owners & managing parties 1
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 |
|---|---|---|---|
| Vinh Buu | 5% Or Greater Direct Ownership Interest | Dec 29, 2022 | 100% |
| Corporate Officer | Dec 29, 2022 | 100% | |
| Corporate Director | Dec 29, 2022 | 100% | |
| W-2 Managing Employee | Dec 29, 2022 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1549411200000",
"number": "1821553553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 E LINCOLN AVE STE 204",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928054347",
"telephone_number": "657-208-1813",
"fax_number": "714-333-4638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E LINCOLN AVE STE 204",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928054347",
"telephone_number": "657-208-1813",
"fax_number": "714-333-4638"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOYALTY HOSPICE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-06",
"last_updated": "2019-02-06",
"status": "A",
"authorized_official_last_name": "MISA",
"authorized_official_first_name": "PROCOPIO",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "657-208-1813"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECRETARY OF STATE",
"identifier": "C4238324",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.