Active NPI
Prestige Colorado Home Health LLC
- Home Health Agency
- Aurora, CO
National Provider Identifier
1053070516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 LLC
- Ownership
- -
- Certified
- Sep 15, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Yordanos Lingane | 5% Or Greater Direct Ownership Interest | Dec 10, 2021 | 50% |
| Corporate Officer | Dec 10, 2021 | 50% | |
| Corporate Director | Dec 10, 2021 | 50% | |
| W-2 Managing Employee | Dec 10, 2021 | 50% | |
| Birhanu Taye | 5% Or Greater Direct Ownership Interest | Dec 10, 2021 | 50% |
| Corporate Officer | Dec 10, 2021 | 50% | |
| Corporate Director | Dec 10, 2021 | 50% | |
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.