Active NPI
Associate Home Health Care Inc
- Home Health Agency
- Manteca, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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, 2015
- 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
- Mr. Praveen Kumar
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Inc
- Overall star rating
- Ownership
- -
- Certified
- Nov 18, 2021
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Thresiamma J Pallivathucal | 5% Or Greater Direct Ownership Interest | Aug 15, 2024 | 30% |
| Corporate Officer | Aug 15, 2024 | 30% | |
| Corporate Director | Aug 15, 2024 | 30% | |
| W-2 Managing Employee | Sep 1, 2015 | 30% | |
| Dinil Joy | 5% Or Greater Direct Ownership Interest | Aug 15, 2024 | 20% |
| Corporate Officer | Aug 15, 2024 | 20% | |
| Corporate Director | Aug 15, 2024 | 20% | |
| W-2 Managing Employee | Aug 15, 2024 | 20% | |
| Mathews George | 5% Or Greater Direct Ownership Interest | Aug 15, 2024 | 30% |
| Corporate Officer | Aug 15, 2025 | 30% | |
| Corporate Director | Sep 1, 2015 | 30% | |
| Praveen Kumar | 5% Or Greater Direct Ownership Interest | Aug 15, 2024 | 20% |
| Corporate Officer | Sep 1, 2015 | 20% | |
| Corporate Director | 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.
-
- Physical Therapy Assistant
- Modesto, CA
- NPI 1801130299
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.