Umbrella Hospice, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

UMBRELLA HOSPICE, INC

Practice address

4221 Wilshire Blvd Ste 170-14
Los Angeles, CA 90010-3519

Phone

(323) 272-3648

Fax

(323) 272-3680

NPI assigned

May 23, 2019

Last updated

Sep 29, 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

Sojung Suk, AGNP-PCNPI 1811376056

Title

Administrator

Phone

(323) 272-3648

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 1922665991. Details of each certification follow.

• CCN B21603 Hospice · Active · Details

Hospice certification: CCN B21603

Legal name

UMBRELLA HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 20, 2021

Last certification

Mar 20, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Enrollment address

4221 Wilshire Blvd
Ste 170-14
Los Angeles, CA 90010-3519

Listed as

Umbrella Hospice, IncCCN B21603 · All quality measures

Ownership

For-Profit

Certified

Mar 20, 2021

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 5

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 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jae Hoon Lee, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Santa Ana, CA
  • NPI 1912105297

  Contracted Managing Employee

  CMS ownership
• Sojung Suk, DNP

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
  • NPI 1811376056

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 2

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.

• Sojung Suk, DNP

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
  • NPI 1811376056
  NPD Authorized official
• Jeongran Chae, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1083473177
  NPD

Affiliated clinicians 1

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

• Paula Bailey-Walton, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1174646590

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1922665991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 170-14",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103519",
            "telephone_number": "323-272-3648",
            "fax_number": "323-272-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 170-14",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103519",
            "telephone_number": "323-272-3648",
            "fax_number": "323-272-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMBRELLA HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "SUK",
        "authorized_official_first_name": "SOJUNG",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-272-3648",
        "authorized_official_credential": "AGNP-PC"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elida Raquel Umanamenendez
• Laura Suyapa Umanzor-Parada, LCSW
• Soban Umar, M.D., PH.D.
• Len Umayam
• Rebecca Umayam, F.N.P
• Joseph Robert Umbrino, NURSE PRACTITIONER
• Umc Pharmacy Inc (UMC Pharmacy)
• Miyuki Umeda
• Deborah Umeh, NP-C
• Madeleine Ngozi Umeh

• Community Based Hospice Care Agency in Los Angeles, CA
• Providers in Los Angeles, 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 Sep 29, 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.