Organization Active NPI

Frieden Hospice Care

  • Community Based Hospice Care Agency
  • Van Nuys, CA
National Provider Identifier
1952929069
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
FRIEDEN HOSPICE CARE
Practice address
6308 Woodman Ave Ste 207
Van Nuys, CA 91401-2388
Phone
(818) 538-5303
NPI assigned
Jul 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Vartan Mamikonjan
Title
Ceo
Phone
(818) 538-5303

Specialties & licenses 1

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

Addresses

Primary practice location

6308 Woodman Ave Ste 207
Van Nuys, CA 91401-2388

Mailing address

6308 Woodman Ave Ste 207
Van Nuys, CA 91401-2388
Phone (818) 538-5303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401002000 CA Part A Provider - Hospice 5496162737 Practice locations: Van Nuys, CA

Hospice certification: CCN B31720

Legal name
FRIEDEN HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 25, 2022
Last certification
Feb 25, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 23, 2019 in CA
Enrollment address
6308 Woodman Ave
Ste 207
Van Nuys, CA 91401-2388

Care Compare: Hospice

Medicare Care Compare
Listed as
Frieden Hospice CareCCN B31720 · All quality measures
Certified
Feb 25, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

6308 Woodman Ave
Ste 207
Van Nuys, CA 91401
Phone (818) 538-5303

Ownership & related parties

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.

NameRoleSinceShare
Jeffrey Shukhman Individual Contracted Managing EmployeeMD; Mar 1, 2024
Joy Michelle Moises Individual W-2 Managing EmployeeAd; Mar 1, 2024
Vartan Mamikonjan Individual 5% Or Greater Direct Ownership Interest Oct 23, 2019 100%
Corporate OfficerCeo/Cfo/Secretary/Owner Oct 23, 2019 100%
Corporate DirectorCeo/Cfo/Secretary/Owner Oct 23, 2019
W-2 Managing Employee Oct 23, 2019
Julna Jerry Carrillo Individual W-2 Managing EmployeeDPCS/Administrator Oct 23, 2019

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1952929069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 WOODMAN AVE STE 207",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012388",
            "telephone_number": "818-538-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 WOODMAN AVE STE 207",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012388",
            "telephone_number": "818-538-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEDEN HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "MAMIKONJAN",
        "authorized_official_first_name": "VARTAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-538-5303"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.