Serenity Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SERENITY HOME HEALTH CARE INC

Practice address

393 Dunlap St N Ste 880
Saint Paul, MN 55104-4204

Phone

(651) 350-7100

Fax

(651) 350-7104

NPI assigned

Sep 5, 2019

Last updated

Dec 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohamed Ismail Ahmed

Title

Ceo

Phone

(614) 254-2005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1023667706. Details of each certification follow.

• CCN 248159 Home health agency · Active · Details
• CCN 24K001 Home health agency · Active · Name & address match · Details

Home health agency certification: CCN 248159

Legal name

SERENITY HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 5, 2022

Last certification

Sep 22, 2022

Organization structure

CorporationProprietary

Incorporated

Jul 13, 2019 in MN

Enrollment address

393 Dunlap St N
Ste 880
Saint Paul, MN 55104-4204

Home health agency certification: CCN 24K001

Legal name

Serenity Home Health Care Inc

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 5, 2022

Last certification

Oct 5, 2022

Facility address

393 N Dunlap Street Ste 880
St. Paul, MN 55104

Listed as

Serenity Home Health Care IncCCN 248159 · All quality measures

Ownership

-

Certified

Oct 5, 2022

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.

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1023667706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N STE 880",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044204",
            "telephone_number": "614-254-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N STE 880",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044204",
            "telephone_number": "651-350-7100",
            "fax_number": "651-350-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "ISMAIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-254-2005"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.