Organization Active NPI

Nursing Home Care Management Inc.,

Doing business as Prestige Home Care Agency

  • Home Health Agency
  • Philadelphia, PA
National Provider Identifier
1063426831
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1000077100005 Issued in PA
Legal business name
NURSING HOME CARE MANAGEMENT INC.,
Doing business as
Prestige Home Care Agency
Practice address
10890 Bustleton Ave
Ste. 211
Philadelphia, PA 19116-3313
Phone
(215) 677-3299
Fax
(215) 677-9811
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Ms. Volha Volosevich, LPCNPI 1831777069
Title
Administrator
Phone
(215) 677-3299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1000077100005 PA Primary
Home Health Agency 251E00000X 1000077100006 PA
Home Health Agency 251E00000X 397658 PA
Home Health Agency 251E00000X 1000077100002 PA
Home Health Agency 251E00000X 1000077100011 PA
Home Health Agency 251E00000X 1000077100010 PA
Community/Behavioral Health Agency 251S00000X 1000077100013 PA
Community/Behavioral Health Agency 251S00000X 1000077100001 PA

Addresses

Primary practice location

10890 Bustleton Ave
Ste. 211
Philadelphia, PA 19116-3313

Mailing address

10890 Bustleton Ave
Ste. 211
Philadelphia, PA 19116-3313
Phone (215) 677-3299

Other identifiers 10

IdentifierTypeStateIssuer
1000077100011MedicaidPA
1000077100015MedicaidPA
1000077100010MedicaidPA
1000077100006MedicaidPA
1000077100014MedicaidPA
1000077100012MedicaidPA
1000077100001MedicaidPA
1000077100005MedicaidPA
1000077100002MedicaidPA
1000077100013MedicaidPA

Other names 1

  • Prestige Home Care Agency Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100512000200 PA Part A Provider - Home Health Agency 3476681404 Practice locations: Philadelphia, PA
O20220426001355 PA MDPP Supplier - in-Person MDPP Supplier 3476681404 Practice locations: Philadelphia, PA
O20260326000944 PA Part B Supplier - Clinic/Group Practice 3476681404 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

Home health agency certification: CCN 397658

Legal name
NURSING HOME CARE MANAGEMENT INC.,
Doing business as
PRESTIGE HOME CARE AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 5, 1996
Last certification
Oct 19, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 8, 1995 in PA
Enrollment address
10890 Bustleton Ave
Ste 211
Philadelphia, PA 19116-3366

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prestige Home Care AgencyCCN 397658 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jan 5, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, 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
39D0938826Prestige Home Care Agency10890 Bustleton Avenue Ste 211, Philadelphia, PA 19116Certificate of waiverJan 14, 2028

National Provider Directory

National Provider Directory

Locations

10890 Bustleton Ave
Ste 211
Philadelphia, PA 19116
Phone (215) 383-0797

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Alexander Dorfman Individual Corporate OfficerPresident Jan 1, 1996
Volha Volosevich Individual W-2 Managing EmployeeAdministrator Oct 13, 2019
Iren Goroshovsky Individual 5% Or Greater Direct Ownership Interest Dec 12, 2022 50%
Alla Dorfman Individual 5% Or Greater Direct Ownership InterestTreasurer Jan 1, 1996 50%
Corporate DirectorTreasurer Jan 1, 1996
Tanya Chumak Individual W-2 Managing EmployeeNursing Supervisor Jan 1, 2013
Dayana Emgushova Individual W-2 Managing EmployeeHuman Resources Jan 1, 2013

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1063426831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10890 BUSTLETON AVE",
            "address_2": "STE. 211",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163313",
            "telephone_number": "215-677-3299",
            "fax_number": "215-677-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10890 BUSTLETON AVE",
            "address_2": "STE. 211",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163313",
            "telephone_number": "215-677-3299",
            "fax_number": "215-677-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSING HOME CARE MANAGEMENT INC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "VOLOSEVICH",
        "authorized_official_first_name": "VOLHA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-677-3299",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "1000077100005",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "1000077100006",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "397658",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "1000077100002",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "1000077100011",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "1000077100010",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "1000077100013",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "1000077100001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100011",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100015",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100010",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100014",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100012",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000077100013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Home Care Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prestige Home Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.