Caring Shield Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CARING SHIELD HOSPICE INC

Doing business as

Imperial Hospice and Palliative Care

Practice address

3538 Central Ave # 322
Riverside, CA 92506-2731

Phone

(951) 742-7677

Fax

(951) 742-7676

NPI assigned

Oct 3, 2014

Organization subpart

No

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

Authorized official

Name

Samad Lakhani

Title

Ceo

Phone

(951) 742-7677

Specialties & licenses 1

Addresses

Other names 1

• Imperial Hospice and Palliative Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A01606

Legal name

CARING SHIELD HOSPICE INC

Doing business as

IMPERIAL HOSPICE AND PALLIATIVE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 12, 2018

Last certification

Sep 12, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Aug 12, 2014 in CA

Enrollment address

3538 Central Ave
Ste 110
Riverside, CA 92506-2700

Listed as

Caring Shield Hospice, IncCCN A01606

Ownership

For-Profit

Certified

Sep 12, 2018

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 4

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.

• Wahid Midou, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Apple Valley, CA
  • NPI 1275563967

  Contracted Managing Employee

  CMS ownership
• Eleazar Somintac Tayag, PT

  • Physical Therapist
  • Victorville, CA
  • NPI 1245355783

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 1

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

• Eleazar Somintac Tayag, PT

  • Physical Therapist
  • Victorville, CA
  • NPI 1245355783
  NPD

Affiliated clinicians 1

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

• Mazen K Munir, MD

  • Family Medicine Physician
  • Apple Valley, CA
  • NPI 1205943446

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1932502945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 CENTRAL AVE # 322",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062731",
            "telephone_number": "951-742-7677",
            "fax_number": "951-742-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3538 CENTRAL AVE # 322",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062731",
            "telephone_number": "951-742-7677",
            "fax_number": "951-742-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARING SHIELD HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "LAKHANI",
        "authorized_official_first_name": "SAMAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-742-7677"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Riverside, CA
• Providers in Riverside, 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 Nov 19, 2024; 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.