San Antonio Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SAN ANTONIO HOSPICE, INC.

Doing business as

Olympia Hospice and Palliative Care

Practice address

419 W Colorado St Ste B
Glendale, CA 91204-3042

Phone

(818) 238-9999

Fax

(818) 238-9997

NPI assigned

Apr 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Arman Nazaryan

Title

Ceo

Phone

(818) 395-4016

Specialties & licenses 1

Addresses

Other names 1

• Olympia Hospice and Palliative Care Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 921636

Legal name

SAN ANTONIO HOSPICE, INC.

Doing business as

OLYMPIA HOSPICE AND PALLIATIVE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 1, 2015

Last certification

May 8, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 29, 2009 in CA

Enrollment address

419 W Colorado St
Ste B
Glendale, CA 91204-3042

Listed as

Olympia Hospice and Palliative CareCCN 921636 · All quality measures

Ownership

For-Profit

Certified

Nov 1, 2015

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 2

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 1

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

• Andrew Lovett Jones, M.D., M.S.

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1437470465

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 3

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

• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Cypress, CA
  • NPI 1770783896

  Hospice

  Care Compare affiliation
• Anil K Hanuman, D,O.

  • Hospitalist Physician
  • Pasadena, CA
  • NPI 1023101813

  Hospice

  Care Compare affiliation
• Andrew Lovett Jones, M.D., M.S.

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1437470465

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1982929774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 W COLORADO ST STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043042",
            "telephone_number": "818-238-9999",
            "fax_number": "818-238-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W COLORADO ST STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043042",
            "telephone_number": "818-238-9999",
            "fax_number": "818-238-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "NAZARYAN",
        "authorized_official_first_name": "ARMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-395-4016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "olympiahospice.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "419 W Colorado St Ste B",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912043042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Olympia Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sondra Kay Samples, AUDIOLOGIST
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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 Jan 16, 2023; 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.