NPIMap

Organization Active NPI

Professional Home Care, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Ithaca, NY
National Provider Identifier
1073675450
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROFESSIONAL HOME CARE, INC.
Practice address
222 Elmira Rd
Suite 4
Ithaca, NY 14850-5349
Phone
(607) 257-1425
Fax
(607) 257-1389
NPI assigned
Dec 14, 2006
Last updated
Jul 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Mr. Joseph Cerra
Title
President and Ceo
Phone
(607) 763-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

222 Elmira Rd
Suite 4
Ithaca, NY 14850-5349

Mailing address

601 Riverside Dr
Johnson City, NY 13790-2544
Phone (607) 763-5600

Other identifiers 1

IdentifierTypeStateIssuer
01762014MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150316000696 NY DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 2466579560 Practice locations: Ithaca, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Professional Home Care Inc222 Elmira Rd, Ithaca, NY 14850-5349(607) 257-1425 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|(TENS) Transcutaneous Electrical Nerve Sti… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Professional Home Care6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 Elmira Rd
Ste 4
Ithaca, NY 14850
Phone (607) 257-1425

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1073675450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RIVERSIDE DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902544",
            "telephone_number": "607-763-5600",
            "fax_number": "607-763-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ELMIRA RD",
            "address_2": "SUITE 4",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505349",
            "telephone_number": "607-257-1425",
            "fax_number": "607-257-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "CERRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "607-763-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01762014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.