Independent Home Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

INDEPENDENT HOME CARE INC

Practice address

9892 Bustleton Ave
Suite 203
Philadelphia, PA 19115-2184

Phone

(215) 322-4353

Fax

(215) 322-4354

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Anna Krupovlyanskaya

Title

Ceo

Phone

(215) 322-4353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Home health agency certification: CCN 398090

Legal name

INDEPENDENT HOME CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 24, 2008

Last certification

Nov 17, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Nov 26, 2006 in PA

Enrollment address

9892 Bustleton Ave
Ste 203
Philadelphia, PA 19115-2139

Listed as

Independent Home Care AgencyCCN 398090

Ownership

Proprietary

Certified

Oct 24, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical 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

All disclosed owners & managing parties 5

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

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1013190768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-322-4353",
            "fax_number": "215-322-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-322-4353",
            "fax_number": "215-322-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "KRUPOVLYANSKAYA",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-322-4353",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.