Interim HHA of St Augustine Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA20589096 Issued in FL

Legal business name

INTERIM HHA OF ST AUGUSTINE INC

Practice address

3440 US 1 S
Building 400, Suite 404
St Augustine, FL 32086-6363

Phone

(904) 824-6123

Fax

(904) 829-0999

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Steven James Alessandro

Title

Ceo

Phone

(847) 457-1808

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 107264

Legal name

INTERIM HHA OF ST. AUGUSTINE INC

Doing business as

INTERIM HEALTHCARE OF ST AUGUSTINE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 12, 1988

Last certification

Mar 20, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

570 Memorial Cir
Ste 330
Ormond Beach, FL 32174-5060

Listed as

Interim HHA of St Augustine IncCCN 107264

Overall star rating

3 of 5

Ownership

Proprietary

Certified

Aug 12, 1988

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

All disclosed owners & managing parties 3

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

Affiliated clinicians 4

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

• Evangeline Diaz Butler, APRN FNP BC

  • Nurse Practitioner
  • Palm Coast, FL
  • NPI 1710544911

  Home health agency

  Care Compare affiliation
• Matthew Dorman, MD

  • Family Medicine Physician
  • Palm Coast, FL
  • NPI 1740284439

  Home health agency

  Care Compare affiliation
• Carl R Freeman, MD

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1326206921

  Home health agency

  Care Compare affiliation
• Nicole C Gortaire, DPM

  • Foot Surgery Podiatrist
  • St Augustine, FL
  • NPI 1174148613

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1003899550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 BAYMEADOWS WAY STE 107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566829",
            "telephone_number": "904-448-1133",
            "fax_number": "904-448-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 US 1 S",
            "address_2": "BUILDING 400, SUITE 404",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866363",
            "telephone_number": "904-824-6123",
            "fax_number": "904-829-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HHA OF ST AUGUSTINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "ALESSANDRO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-457-1808"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA20589096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Island Family Pharmacy Inc

• Home Health Agency in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.