Organization Active NPI

Prestige Colorado Home Health LLC

  • Home Health Agency
  • Aurora, CO
National Provider Identifier
1053070516
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRESTIGE COLORADO HOME HEALTH LLC
Practice address
22450 E Fair PL
Aurora, CO 80015-6637
Phone
(720) 341-6092
NPI assigned
Dec 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Yordanos Lingane
Title
Owner
Phone
(720) 341-6092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

22450 E Fair PL
Aurora, CO 80015-6637

Mailing address

22450 E Fair PL
Aurora, CO 80015-6637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230313001557 CO Part A Provider - Home Health Agency 5092189126 Practice locations: Aurora, CO

Home health agency certification: CCN 067635

Legal name
PRESTIGE COLORADO HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 15, 2023
Last certification
Sep 15, 2023
Organization structure
LLCProprietary
Incorporated
Dec 10, 2021 in CO
Enrollment address
22450 E Fair PL
Aurora, CO 80015-6637

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prestige Colorado Home Health LLCCCN 067635
Ownership
-
Certified
Sep 15, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Yordanos Lingane Individual 5% Or Greater Direct Ownership InterestVice President, Secretary Dec 10, 2021 50%
Corporate OfficerVice President, Secretary Dec 10, 2021 50%
Corporate DirectorVice President, Secretary Dec 10, 2021 50%
W-2 Managing EmployeeVice President, Secretary Dec 10, 2021 50%
Birhanu Taye Individual 5% Or Greater Direct Ownership InterestPresident, Treasurer Dec 10, 2021 50%
Corporate OfficerPresident, Treasurer Dec 10, 2021 50%
Corporate DirectorPresident,Treasurer Dec 10, 2021 50%
W-2 Managing EmployeePresident,Treasurer Dec 10, 2021 50%

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1053070516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22450 E FAIR PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800156637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22450 E FAIR PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800156637",
            "telephone_number": "720-341-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE COLORADO HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "LINGANE",
        "authorized_official_first_name": "YORDANOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-341-6092"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.