SH Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SH HOSPICE INC.

Practice address

45 W Easy St Ste 30
Simi Valley, CA 93065-1610

Phone

(805) 600-8007

Fax

(805) 600-0047

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By 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

Hayk Komurjyan

Title

Ceo/Cfo

Phone

(805) 600-8007

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821694076. Details of each certification follow.

• CCN B51684 Hospice · Active · Details

Hospice certification: CCN B51684

Legal name

SH HOSPICE INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 15, 2023

Last certification

Mar 2, 2023

Organization structure

CorporationProprietary

Incorporated

Nov 9, 2020 in CA

Enrollment address

45 W Easy St
Ste 30
Simi Valley, CA 93065-1610

Listed as

SH Hospice IncCCN B51684 · All quality measures

Certified

Mar 15, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

Affiliated clinicians 1

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

• Richard Kenneth Gordon, M.D.

  • Specialist
  • Northridge, CA
  • NPI 1144242645

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1821694076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W EASY ST STE 30",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651610",
            "telephone_number": "805-600-8007",
            "fax_number": "805-600-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W EASY ST STE 30",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651610",
            "telephone_number": "805-600-8007",
            "fax_number": "805-600-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "KOMURJYAN",
        "authorized_official_first_name": "HAYK",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "805-600-8007"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda J Setto, OD, FAAO
• Garrett Patrick Seward
• SH Home Health Inc
• Farridah Shafiee, D.O.
• Priti Shah, M.S., CCC
• Danielle Stephanie Shamam
• Mary Shams, PHARMD
• Shahrzad Shareghi, M.D.

• Community Based Hospice Care Agency in Simi Valley, CA
• Providers in Simi Valley, 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 Dec 11, 2020; 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.