Organization Active NPI

Etairos Care at Home Inc

Doing business as Comprehensive Home Care of Palm Beach

  • Home Health Agency
  • West Palm Beach, FL
National Provider Identifier
1043257199
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA299991293 Issued in FL
Legal business name
ETAIROS CARE AT HOME INC
Doing business as
Comprehensive Home Care of Palm Beach
Practice address
2000 Palm Beach Lakes Blvd Ste 602
West Palm Beach, FL 33409-6505
Phone
(561) 588-0996
Fax
(561) 488-0446
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Brett Rager
Title
VP Reimbursement
Phone
(727) 614-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA299991293 FL Primary

Addresses

Primary practice location

2000 Palm Beach Lakes Blvd Ste 602
West Palm Beach, FL 33409-6505

Mailing address

13787 Belcher Rd S Ste 220
Largo, FL 33771-4065

Other names 1

  • Comprehensive Home Care of Palm Beach Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210305001731 FL Part A Provider - Home Health Agency 9537572912 Practice locations: West Palm Beach, FL

Home health agency certification: CCN 107625

Legal name
ETAIROS CARE AT HOME INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 14, 2000
Last certification
Sep 30, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 11, 2020 in DE
Enrollment address
2001 Palm Beach Lakes Blvd
Ste 413
West Palm Beach, FL 33409-6516
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Etairos Care at Home, Inc.CCN 107625 · All quality measures
Ownership
Proprietary
Certified
Dec 14, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1011637Etairos Care at Home, Inc2001 Palm Beach Lakes Blvd, Ste 413, West Palm Beach, FL 33409Certificate of waiverApr 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Home Care of Palm Beach5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4915 S Congress Ave
Ste A
Palm Springs, FL 33461
Phone (561) 313-0840

2001 Palm Beach Lakes Blvd
Ste 413
West Palm Beach, FL 33409
Phone (727) 723-7532

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Jeffrey Freedman Individual Corporate Officer Dec 28, 2020
Etairos Health Inc Organization, Largo, FL Corporation 5% Or Greater Direct Ownership Interest Mar 31, 2020 100%
Richard Butler Individual Corporate OfficerChief Operating Officer Oct 1, 2020
Operational/Managerial Control Oct 1, 2020

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Change-of-ownership history 2

DateEventCounterparty
Oct 1, 2020 Change of OwnershipThis provider was the buyer Comprehensive Home Care of Palm Beach; Comprehensive Home Care of MartCCN 107625, FL, NPI 1043257199
Oct 1, 2020 Change of OwnershipThis provider was the seller Etairos Care at Home IncCCN 107625, FL, NPI 1043257199

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1043257199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13787 BELCHER RD S STE 220",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337714065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PALM BEACH LAKES BLVD STE 602",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096505",
            "telephone_number": "561-588-0996",
            "fax_number": "561-488-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETAIROS CARE AT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "RAGER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "727-614-8300"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299991293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Home Care of Palm Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive Home Care of Palm Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.