St. Bernardine Care Providers,Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ST. BERNARDINE CARE PROVIDERS,INC.

Practice address

18064 Wika Rd Ste 202
Apple Valley, CA 92307-2182

Phone

(760) 242-6720

Fax

(760) 242-6731

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Masoud Shojaei

Title

Cfo

Phone

(949) 397-6091

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 753151

Legal name

ST. BERNARDINE CARE PROVIDERS INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 13, 2021

Last certification

Aug 31, 2021

Organization structure

CorporationProprietary

Incorporated

Sep 26, 2006 in CA

Enrollment address

6 Venture
Ste 375
Irvine, CA 92618-3340

Listed as

St. Bernardine Care Providers Inc.CCN 753151

Overall star rating

3 of 5

Ownership

-

Certified

Sep 13, 2021

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaime Cristobal David, MD

  • Family Medicine Physician
  • Apple Valley, CA
  • NPI 1912056177
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1831246032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VENTURE STE 375",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926187367",
            "telephone_number": "949-397-6091",
            "fax_number": "949-629-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18064 WIKA RD STE 202",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072182",
            "telephone_number": "760-242-6720",
            "fax_number": "760-242-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Venture Ste 375",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926187367",
            "country_code": "US",
            "telephone_number": "949-397-6091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. BERNARDINE CARE PROVIDERS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "SHOJAEI",
        "authorized_official_first_name": "MASOUD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-397-6091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverlee Lynn Spencer
• Sri MD, Inc
• St Jude Hospital Yorba Linda
• St Mary Specialty Clinic
• St. Bernardine Care Providers Inc.
• St. Jude Neighborhood Health Centers
• St. Mary Medical Center
• St. Mary Medical Center
• St. Mary Medical Center
• Paul Andrew Stanton, MD

• Home Health Agency in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.