Organization Active NPI

Comfort Healthcare, LLC

  • Home Health Agency
  • Cleveland, OH
National Provider Identifier
1073605135
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
OH03790 Issued in OH
Legal business name
COMFORT HEALTHCARE, LLC
Practice address
8310 Detroit Ave
Cleveland, OH 44102-1806
Phone
(216) 281-9999
Fax
(216) 281-9990
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mr. Vitaliy A Kutsay
Title
Cfo
Phone
(216) 281-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X OH03790 OH Primary

Addresses

Primary practice location

8310 Detroit Ave
Cleveland, OH 44102-1806

Mailing address

8310 Detroit Ave
Cleveland, OH 44102-1806
Phone (216) 281-9999

Other identifiers 4

IdentifierTypeStateIssuer
165671OtherANTHEM BLUE CROSS AND BLUE SHIELD
2618804MedicaidOH
398662OtherWELLCARE OF OHIO, INC.
745457OtherBUCKEYE COMMUNITY HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050908000189 OH Part A Provider - Home Health Agency 0446282669 Practice locations: Cleveland, OH

Home health agency certification: CCN 368125

Legal name
COMFORT HEALTHCARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 23, 2005
Last certification
Oct 25, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
8310 Detroit Ave
Cleveland, OH 44102-1806

Care Compare: Home health agency

Medicare Care Compare
Listed as
Comfort Healthcare, LLCCCN 368125 · All quality measures
Ownership
Proprietary
Certified
Nov 23, 2005
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
36D1038454Comfort Healthcare LLC8310 Detroit Avenue, Cleveland, OH 44102Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

8310 Detroit Ave
Cleveland, OH 44102
Phone (216) 281-9999

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Patricia Ruzicka Individual Corporate OfficerDirector of Nursing Mar 1, 2016
Corporate DirectorBoard Member Mar 1, 2016
W-2 Managing EmployeeDirector of Nursing Mar 1, 2016
Sheldon H Rose Individual Corporate DirectorBoard Member May 4, 2011
Operational/Managerial ControlMedical Director May 4, 2011
Vitaliy Kutsay Individual 5% Or Greater Direct Ownership InterestOwner Nov 16, 2005 40%
Corporate OfficerCfo Nov 16, 2005
Corporate DirectorBoard Member Apr 3, 2006
Operational/Managerial ControlAssistant Administrator Nov 16, 2005
Kirill Simakovsky Individual 5% Or Greater Direct Ownership InterestOwner Nov 16, 2005 60%
Corporate OfficerPresident Nov 16, 2005
Corporate DirectorBoard Member Apr 3, 2006
Operational/Managerial ControlAdministrator Nov 16, 2005

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1073605135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021806",
            "telephone_number": "216-281-9999",
            "fax_number": "216-281-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021806",
            "telephone_number": "216-281-9999",
            "fax_number": "216-281-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "KUTSAY",
        "authorized_official_first_name": "VITALIY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "216-281-9999",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "OH03790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLUE SHIELD",
            "identifier": "165671",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2618804",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF OHIO, INC.",
            "identifier": "398662",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMMUNITY HEALTH PLAN",
            "identifier": "745457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.