Elements of Elder Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ELEMENTS OF ELDER CARE

Practice address

2990 E Northern Ave Ste C103
Phoenix, AZ 85028-4839

Phone

(602) 641-9505

NPI assigned

Apr 9, 2020

Last updated

Jul 14, 2022By 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

Ray Park

Title

Statutory Agent

Phone

(602) 641-9505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821617960. Details of each certification follow.

• CCN 031721 Hospice · Active · Details

Hospice certification: CCN 031721

Legal name

ELEMENTS OF ELDER CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 15, 2020

Last certification

Oct 15, 2020

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Incorporated

Mar 12, 2020 in WY

Enrollment address

2990 E Northern Ave
Ste C103
Phoenix, AZ 85028-4839

Listed as

Elements of Elder Care LLCCCN 031721 · All quality measures

Ownership

For-Profit

Certified

Oct 15, 2020

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

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.

• Marco Valerio Canulla, MD

  • Surgery Physician
  • Litchfield Park, AZ
  • NPI 1194700286

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• True Heart Hospice and Palliative Care of Texas LLC

  • Community Based Hospice Care Agency
  • Temple, TX
  • NPI 1790314169

  Cranage LLC

  CMS ownership
• True Heart Hospice LLC

  • Community Based Hospice Care Agency
  • Temple, TX
  • NPI 1376058925

  Cranage LLC

  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.

• Camelia Vilceanu, NP

  • Family Nurse Practitioner
  • Glendale, AZ
  • NPI 1225825060

  Family Medicine

  NPD (past)

Affiliated clinicians 1

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

• Marco Valerio Canulla, MD

  • Surgery Physician
  • Litchfield Park, AZ
  • NPI 1194700286

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1821617960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 E NORTHERN AVE STE C103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 E NORTHERN AVE STE C103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284839",
            "telephone_number": "602-641-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTS OF ELDER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "STATUTORY AGENT",
        "authorized_official_telephone_number": "602-641-9505"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.