Active NPI
Physiocare Home Healthcare LLC
- Home Health Agency
- West Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 11-012233
- Legal business name
- PHYSIOCARE HOME HEALTHCARE LLC
- Practice address
- 1440 Innovation PL
West Lafayette, IN 47906-1000 - Phone
- (765) 838-1660
- Fax
- (765) 838-1662
- NPI assigned
- Oct 28, 2009
- 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
- Derek Stotz
- Title
- Ceo
- Phone
- (917) 882-8513
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Health Agency | 251E00000X | 11-012233 | IN | Primary |
Addresses
Primary practice location
1440 Innovation PL
West Lafayette, IN 47906-1000
Mailing address
1440 Innovation PL
West Lafayette, IN 47906-1000
Phone (765) 838-1660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15K055 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100608000110 | IN | Part A Provider - Home Health Agency | 7012047772 | Practice locations: West Lafayette, IN |
Home health agency certification: CCN 157624
- Legal name
- PHYSIOCARE HOME HEALTHCARE LLC
- Doing business as
- SELECT HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 19, 2010
- Last certification
- Jul 19, 2010
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Oct 9, 2009 in IN
- Enrollment address
- 1440 Innovation PL
West Lafayette, IN 47906-1000
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Physiocare Home Healthcare LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jul 19, 2010
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
700 E Firmin St
Ste 125
Kokomo, IN 46902
401 S Earl Ave
Ste 1A
Lafayette, IN 47904
Phone (765) 337-6880
510 Veterans Memorial Pkwy E
Lafayette, IN 47905
Phone (765) 427-6116
625 S Earl Ave
Ste D
Lafayette, IN 47904
Phone (765) 838-1660
1440 Innovation Pl
West Lafayette, IN 47906
Phone (765) 250-3827
Ownership & related parties
All disclosed owners & managing parties 13
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 |
|---|---|---|---|
| Lauren G Levinger | Corporate Director | Dec 1, 2023 | |
| W-2 Managing Employee | Dec 1, 2023 | ||
| East Rock DJMD Fund, LP | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 7.77% |
| East Rock Granite Fund, LP | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 5.94% |
| Fortis Home Health and Hospice, LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 100% |
| Derek Stotz | Corporate Officer | Jul 11, 2025 | |
| SHH Holdco, Inc. | 5% Or Greater Direct Ownership Interest | Dec 1, 2023 | 100% |
| TMM Holdings, Inc. | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 13.9% |
| Gac-Fortis, LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 77.5% |
| East Rock Lorelei Fund LP | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 5.49% |
| East Rock Victoria Fund, LP | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 22.56% |
| Dominique Smith | Corporate Director | Oct 19, 2025 | |
| W-2 Managing Employee | Oct 19, 2025 | ||
| Texas Emerging Managers Private Markets Program, LP | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 6.86% |
| Eref Special Situations, LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 | 22.86% |
Facilities with the same owner 7
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- West Lafayette, IN
- NPI 1760779078
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Markets Program, LP, TMM Holdin
-
- Home Health Agency
- Carmel, IN
- NPI 1689979965
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Markets Program, LP, TMM Holdin
-
- Community Based Hospice Care Agency
- Carmel, IN
- NPI 1023709847
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, SHH Holdco, Inc., Texas Emerging Managers Private Markets Program, LP, TMM Holdin
-
- Community Based Hospice Care Agency
- Orem, UT
- NPI 1619968781
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP, TMM Holdings, Inc.
-
- Home Health Agency
- Murray, UT
- NPI 1922006493
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP, TMM Holdings, Inc.
-
- Community Based Hospice Care Agency
- Layton, UT
- NPI 1942290960
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP, TMM Holdings, Inc.
-
- Community Based Hospice Care Agency
- Murray, UT
- NPI 1780026617
East Rock DJMD Fund, LP, East Rock Granite Fund, LP, East Rock Victoria Fund, LP, Eref Special Situations, LLC, Fortis Home Health and Hospice, LLC, Gac-Fortis, LLC, Texas Emerging Managers Private Markets Program, LP, TMM Holdings, Inc.
Practitioners & affiliated clinicians
Affiliated clinicians 27
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776988800000",
"number": "1033445895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 INNOVATION PL",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061000",
"telephone_number": "765-838-1660",
"fax_number": "765-838-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 INNOVATION PL",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061000",
"telephone_number": "765-838-1660",
"fax_number": "765-838-1662"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSIOCARE HOME HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-28",
"last_updated": "2026-04-24",
"certification_date": "2026-04-24",
"status": "A",
"authorized_official_last_name": "STOTZ",
"authorized_official_first_name": "DEREK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "917-882-8513"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IN",
"license": "11-012233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15K055",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.