Madrona Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MADRONA HOSPICE CARE INC

Practice address

185 N Redwood Dr Ste 110
San Rafael, CA 94903-1973

Phone

(628) 243-0550

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

Leopoldo Reyes

Title

Ceo

Phone

(628) 243-0550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN A11781

Legal name

MADRONA HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 25, 2021

Last certification

May 25, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jul 24, 2020 in CA

Enrollment address

185 N Redwood Dr
Ste 110
San Rafael, CA 94903-1902

Listed as

Madrona Hospice Care IncCCN A11781

Ownership

For-Profit

Certified

May 25, 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.

Affiliated clinicians 1

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

• Estelita Limbo Carandang, M.D.

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1255473757

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1962011551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 N REDWOOD DR STE 110",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031973",
            "telephone_number": "628-243-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 N REDWOOD DR STE 110",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031973",
            "telephone_number": "628-243-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "LEOPOLDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "628-243-0550"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Kathleen Macdonald, MFT
• Kristina Marie Macias
• Karen Maciejko, NP
• Corrissa Madden-Grubb
• Melina Madrigal
• Aaron Magee
• Elizabeth Magid, MSW
• Janelle R Maglione
• Luke Daniel Cruz Magsino
• Joan Torio Mah, O.D.

• Community Based Hospice Care Agency in San Rafael, CA
• Providers in San Rafael, 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 Dec 2, 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.