Active NPI
Luxor Care Inc
- Home Health Agency
- Vallejo, CA
National Provider Identifier
1003216896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- LUXOR CARE INC
- Practice address
- 160 Glen Cove Marina Rd E Ste 101
Vallejo, CA 94591-7290 - Phone
- (707) 561-8008
- NPI assigned
- Aug 28, 2014
- 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
- Alphie De Guzman
- Title
- President
- Phone
- (707) 561-8008
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
160 Glen Cove Marina Rd E Ste 101
Vallejo, CA 94591-7290
Mailing address
301 Georgia St
Suite 316
Vallejo, CA 94590-5946
Other names 1
- Luxor Care Home Health Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141029001576 | CA | Part A Provider - Home Health Agency | 5890916118 | Practice locations: Vallejo, CA |
Home health agency certification: CCN 059681
- Legal name
- LUXOR CARE INC
- Doing business as
- LUXOR CARE HOME HEALTH SERVICES
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 11, 2015
- Last certification
- Dec 11, 2015
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 15, 2014 in CA
- Enrollment address
- 301 Georgia St 316
Vallejo, CA 94590-5997
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Luxor Care Home Health Services
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 11, 2015
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2094017 | Luxor Care Home Health Services | Certificate of waiver | Apr 7, 2027 |
National Provider Directory
National Provider DirectoryLocations
160 Glen Cove Marina Rd E
Ste 101
Vallejo, CA 94591
Phone (707) 561-8008
301 Georgia St
Ste 316
Vallejo, CA 94590
Phone (707) 561-8008
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Alphie E de Guzman | 5% Or Greater Direct Ownership Interest | Nov 6, 2019 | 100% |
| Corporate Director | Mar 15, 2017 | 100% | |
| W-2 Managing Employee | Mar 15, 2017 | 100% | |
| Saul Cantolino | Corporate Officer | Oct 1, 2021 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 23
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Greenbrae, CA
- NPI 1619917028
Home health agency
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1831137025
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719532800000",
"number": "1003216896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 GEORGIA ST",
"address_2": "SUITE 316",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945905946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 GLEN COVE MARINA RD E STE 101",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945917290",
"telephone_number": "707-561-8008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUXOR CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-28",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A",
"authorized_official_last_name": "DE GUZMAN",
"authorized_official_first_name": "ALPHIE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "707-561-8008"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Luxor Care Home Health Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Luxor Care Home Health Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.