NPIMap

Organization Active NPI

Vantage Hospice, LLC

Doing business as Vantage Hospice

  • Community Based Hospice Care Agency
  • Houston, TX
National Provider Identifier
1962785782
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VANTAGE HOSPICE, LLC
Doing business as
Vantage Hospice
Practice address
5718 Westheimer Rd Ste 1650
Houston, TX 77057-5833
Phone
(281) 579-5660
Fax
(281) 579-5661
NPI assigned
Sep 28, 2011
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Paul Stamatis Jr.
Title
President & Cfo
Phone
(281) 578-4905

Specialties & licenses 1

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

Addresses

Primary practice location

5718 Westheimer Rd Ste 1650
Houston, TX 77057-5833

Mailing address

5718 Westheimer Rd Ste 1650
Houston, TX 77057-5833
Phone (281) 579-5660

Other identifiers 2

IdentifierTypeStateIssuer
001020443MedicaidTX
001020443OtherTXLTCMI

Other names 1

  • Vantage Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111227000612 TX Part A Provider - Hospice 8921274861 Practice locations: Houston, TX; Bryan, TX
O20200520002507 TX Part B Supplier - Clinic/Group Practice 8921274861 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962785782. Details of each certification follow.

Hospice certification: CCN 671680

Legal name
VANTAGE HOSPICE, LLC
Doing business as
VANTAGE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 19, 2011
Last certification
Feb 4, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Aug 25, 2011 in TX
Enrollment address
5718 Westheimer Rd
Ste 1650
Houston, TX 77057-5745

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Vantage Hospice, LLC

    dba Vantage Palliative Care

    • Hospice and Palliative Medicine (Internal Medicine) Physician
    • Houston, TX
    • NPI 1801539515

    8921274861

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Vantage HospiceCCN 671680 · All quality measures
Ownership
Other
Certified
May 19, 2011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

21720 Kingsland Blvd
Ste 301
Katy, TX 77450
Phone (281) 579-5660

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Scott W Breeze Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2020 9.94%
Paul Stamatis Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2011 9.94%
Corporate OfficerCfo Oct 1, 2011
Corporate DirectorCfo Oct 1, 2011
Operational/Managerial ControlCfo Oct 1, 2011
Exceptional Management, LLC Organization, Katy, TX LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2013 12.64%
Juliet S Breeze Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2011 9.94%
Corporate DirectorBoard Member Oct 1, 2011
Operational/Managerial ControlBoard Member Oct 1, 2011
Aneta Nicole Knight Individual W-2 Managing EmployeeAdminstrator Jun 6, 2012
VCH Management LLC Organization, Katy, TX LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2011 31.4%
Operational/Managerial Control Oct 1, 2011
Breeze Family Revocable Trust Organization, Sugar Land, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2020 19.88%
Brenda L Wainscott Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2022 9.94%
Paul and Brenda Stamatis Revocable Trust Organization, Katy, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2022 19.88%
Theodore J Trumble Individual Contracted Managing EmployeeMD; Oct 1, 2011

Owners & managing parties with NPI records 4

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1962785782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 WESTHEIMER RD STE 1650",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575833",
            "telephone_number": "281-579-5660",
            "fax_number": "281-579-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 WESTHEIMER RD STE 1650",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575833",
            "telephone_number": "281-579-5660",
            "fax_number": "281-579-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "STAMATIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT & CFO",
        "authorized_official_telephone_number": "281-578-4905",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020443",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LTCMI",
            "identifier": "001020443",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vantage Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vantage Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.