Organization Active NPI

Associate Home Health Care Inc

  • Home Health Agency
  • Manteca, CA
National Provider Identifier
1033588777
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ASSOCIATE HOME HEALTH CARE INC
Practice address
183 W North St Ste 1
Manteca, CA 95336-4591
Phone
(209) 233-5567
NPI assigned
Sep 23, 2015
Last updated
Sep 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Mr. Praveen KumarNPI 1801130299
Title
Ceo
Phone
(209) 722-8208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

183 W North St Ste 1
Manteca, CA 95336-4591

Mailing address

183 W North St Ste 1
Manteca, CA 95336-4591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160229001706 CA Part A Provider - Home Health Agency 3678878600 Practice locations: Modesto, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033588777. Details of each certification follow.

Home health agency certification: CCN 559607

Legal name
ASSOCIATE HOME HEALTH CARE INC
Doing business as
ASSOCIATE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 18, 2021
Last certification
Nov 18, 2021
Organization structure
CorporationProprietary
Enrollment address
3501 Coffee Rd
Ste 7
Modesto, CA 95355-1343

Care Compare: Home health agency

Medicare Care Compare
Listed as
Associate Home Health Care IncCCN 559607 · All quality measures
Overall star rating
3 of 5
Ownership
-
Certified
Nov 18, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

183 W North St
Ste 1
Manteca, CA 95336
Phone (209) 233-5567

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Thresiamma J Pallivathucal Individual 5% Or Greater Direct Ownership InterestCfo/Board Member Aug 15, 2024 30%
Corporate OfficerCfo/Board Member Aug 15, 2024 30%
Corporate DirectorCfo/Board Member Aug 15, 2024 30%
W-2 Managing EmployeeCfo/Board Member Sep 1, 2015 30%
Dinil Joy Individual 5% Or Greater Direct Ownership InterestBoard Member Aug 15, 2024 20%
Corporate OfficerBoard Member Aug 15, 2024 20%
Corporate DirectorBoard Member Aug 15, 2024 20%
W-2 Managing EmployeeBoard Member Aug 15, 2024 20%
Mathews George Individual 5% Or Greater Direct Ownership InterestSecretary/Board Member Aug 15, 2024 30%
Corporate OfficerSecretary/Board Member Aug 15, 2025 30%
Corporate DirectorSecretary/Board Member Sep 1, 2015 30%
Praveen Kumar Individual 5% Or Greater Direct Ownership InterestCeo/Board Member Aug 15, 2024 20%
Corporate OfficerCeo Sep 1, 2015 20%
Corporate DirectorCeo/Board Member Aug 15, 2024 20%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1033588777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 W NORTH ST STE 1",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 W NORTH ST STE 1",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364591",
            "telephone_number": "209-233-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATE HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-722-8208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.