Dynamic Home Health Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

03750501 Issued in PA

Legal business name

DYNAMIC HOME HEALTH CARE, INC

Practice address

550 State Rd
Suite 104
Bensalem, PA 19020-8702

Phone

(215) 244-4466

NPI assigned

Sep 14, 2009

Last updated

Jun 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ilya Ivanov, RN, EMT

Title

Administrator

Phone

(215) 870-3441

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063745669. Details of each certification follow.

• CCN 398129 Home health agency · Active · Details

Home health agency certification: CCN 398129

Legal name

DYNAMIC HOME HEALTH CARE, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 9, 2010

Last certification

Sep 18, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 1, 2009 in PA

Enrollment address

550 State Rd 113
Bensalem, PA 19020-8700

Listed as

Dynamic Home Health Care IncCCN 398129 · All quality measures

Ownership

Proprietary

Certified

Apr 9, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

Owners & managing parties with NPI records 1

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

• Natalya Temerte, CRNP

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1063804367

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1063745669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 STATE RD",
            "address_2": "SUITE 104",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190208702",
            "telephone_number": "215-244-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 STATE RD",
            "address_2": "SUITE 104",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190208702",
            "telephone_number": "215-244-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HOME HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-870-3441",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, EMT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "03750501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102455620 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.

Verify at the official NPI Registry.