Montana Hospice, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MONTANA HOSPICE, INC

Practice address

1201 N Pacific Ave Ste 103
Glendale, CA 91202-3864

Phone

(818) 453-0033

NPI assigned

Jun 11, 2020

Organization subpart

No

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

Authorized official

Name

Gayane Musayelyan

Title

Ceo

Phone

(818) 453-0033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21548

Legal name

MONTANA HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 30, 2021

Last certification

Mar 30, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 17, 2020 in CA

Enrollment address

1201 N Pacific Ave
Ste 103
Glendale, CA 91202-3864

Listed as

Montana Hospice, IncCCN B21548

Ownership

For-Profit

Certified

Mar 30, 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.

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

• Anahit H Blikian, M.D.

  • Adolescent Medicine (Family Medicine) Physician
  • Glendale, CA
  • NPI 1376596403

  Hospice

  Care Compare affiliation
• Ben Rad, M.D.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1063504249

  Hospice

  Care Compare affiliation
• Robert E Thompson

  • Pulmonary Disease Physician
  • Northridge, CA
  • NPI 1982675666

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1912522293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N PACIFIC AVE STE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023864",
            "telephone_number": "818-453-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N PACIFIC AVE STE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023864",
            "telephone_number": "818-453-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTANA HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MUSAYELYAN",
        "authorized_official_first_name": "GAYANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-453-0033"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Monge
• Monglen Home Care
• Monroe Home Health Care, Inc.
• Monroe Hospice Care, Inc.
• Ellen Monroe
• China M Montanez
• Emily Montanez
• Jackelin Montano, LMFT
• Monte Healthcare
• Monte Vista Home Inc.

• All providers in Glendale, CA
• Community Based Hospice Care Agency in California

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