Active NPI
Medistar Hospice
- Hospice Registered Nurse
- Encino, CA
National Provider Identifier
1982217337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice Registered Nurse
- Legal business name
- MEDISTAR HOSPICE
- Practice address
- 17547 Ventura Blvd Ste 205
Encino, CA 91316-3854 - Phone
- (818) 635-3501
- NPI assigned
- Aug 26, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Inna Zhivilova
- Title
- Owner
- Phone
- (818) 635-3501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice Registered Nurse | 163WH1000X | Primary |
Addresses
Primary practice location
17547 Ventura Blvd Ste 205
Encino, CA 91316-3854
Mailing address
17547 Ventura Blvd Ste 205
Encino, CA 91316-3854
Phone (818) 635-3501
Other names 1
- medistar hospice
Care Compare: Hospice
Medicare Care Compare- Listed as
- Medistar Hospice
- Certified
- Jan 10, 2025
- Medicare certification status
- Active
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598400000000",
"number": "1982217337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17547 VENTURA BLVD STE 205",
"city": "ENCINO",
"state": "CA",
"postal_code": "913163854",
"telephone_number": "818-635-3501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17547 VENTURA BLVD STE 205",
"city": "ENCINO",
"state": "CA",
"postal_code": "913163854",
"telephone_number": "818-635-3501"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDISTAR HOSPICE",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-26",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A",
"authorized_official_last_name": "ZHIVILOVA",
"authorized_official_first_name": "INNA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "818-635-3501"
},
"taxonomies": [
{
"code": "163WH1000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Hospice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "medistar hospice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.