Organization Active NPI

Mission Hospice Services of East Bay LLC

  • Community Based Hospice Care Agency
  • Pleasanton, CA
National Provider Identifier
1831784701
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MISSION HOSPICE SERVICES OF EAST BAY LLC
Practice address
5976 W Las Positas Blvd Ste 118
Pleasanton, CA 94588-8506
Phone
(619) 757-2700
NPI assigned
Mar 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Steve Murphy
Title
SVP, Finance
Phone
(619) 757-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

5976 W Las Positas Blvd Ste 118
Pleasanton, CA 94588-8506

Mailing address

2365 Northside Dr Ste 200
San Diego, CA 92108-2720
Phone (619) 757-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220405000536 CA Part A Provider - Hospice 6406242247 Practice locations: Pleasanton, CA

Hospice certification: CCN A11731

Legal name
MISSION HOSPICE SERVICES OF EAST BAY LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 10, 2021
Last certification
Feb 10, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jan 26, 2021 in CA
Enrollment address
5976 W Las Positas Blvd
Ste 118a
Pleasanton, CA 94588-8506

Care Compare: Hospice

Medicare Care Compare
Listed as
Mission Hospice Services of East Bay, LLCCCN A11731
Certified
Feb 10, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

5976 W Las Positas Blvd
Ste 118A
Pleasanton, CA 94588
Phone (925) 201-3921

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mission Healthcare Intermediate Holdings LLC Organization, San Diego, CA LLC, Holding company 5% Or Greater Indirect Ownership Interest Jan 26, 2021 100%
TVG Bolt Buyer, LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest May 1, 2023 49.05%
Mission Healthcare Services, LLC Organization, San Diego, CA LLC 5% Or Greater Direct Ownership Interest Jan 26, 2021 100%
MH Holdings Management Holdco LLC Organization, Chicago, IL LLC, Holding company 5% Or Greater Indirect Ownership Interest May 1, 2023 20%
Vistria Fund III (Ft) LP Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest May 1, 2023 15.74%
Paul Verhoeve Individual Corporate OfficerCeo Jan 26, 2021
W-2 Managing EmployeeCeo May 1, 2023
Operational/Managerial ControlCeo May 1, 2023
TVG MH Holdings III (Ft) LP Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest May 1, 2023 16.15%
TVG MH Intermediate Holdings LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest Jan 26, 2021 100%
TVG MH III (Ft) Blocker LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest May 1, 2023 16.15%
TVG MH Holdings LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest Jan 26, 2021 100%
Vistria Fund III LP Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest May 1, 2023 32.89%

Facilities with the same owner 94

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

View all 94

Change-of-ownership history 1

DateEventCounterparty
Mar 15, 2021 Change of OwnershipThis provider was the buyer Alliance Hospice CareCCN A11731, CA, NPI 1972086148

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1831784701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 NORTHSIDE DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082720",
            "telephone_number": "619-757-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5976 W LAS POSITAS BLVD STE 118",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888506",
            "telephone_number": "619-757-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOSPICE SERVICES OF EAST BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SVP, FINANCE",
        "authorized_official_telephone_number": "619-757-2700"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.