NPIMap

Organization Active NPI

Age Home Care LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1073362166
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
AGE HOME CARE LLC
Practice address
4224 Whiting Rd
Philadelphia, PA 19154-2832
Phone
(215) 500-4645
NPI assigned
May 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Michelle MatukaNPI 1275356354
Title
President
Phone
(215) 500-4645

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4224 Whiting Rd
Philadelphia, PA 19154-2832

Mailing address

4224 Whiting Rd
Philadelphia, PA 19154-2832
Phone (215) 500-4645

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1073362166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 WHITING RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191542832",
            "telephone_number": "215-500-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 WHITING RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191542832",
            "telephone_number": "215-500-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "MATUKA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-500-4645"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.