All Star Phoenix Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ALL STAR PHOENIX INC.

Practice address

17050 Chatsworth St Ste 222
Granada Hills, CA 91344-7836

Phone

(818) 488-9299

NPI assigned

Aug 16, 2019

Organization subpart

No

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

Authorized official

Name

Zaruhi Virabyan

Title

Ceo

Phone

(818) 488-9299

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559274

Legal name

ALL STAR PHOENIX INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 2, 2020

Last certification

Jun 2, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jun 24, 2019 in CA

Enrollment address

30125 Agoura Rd
Ste 2E
Agoura Hills, CA 91301-4337

Listed as

All Star Phoenix IncCCN 559274

Ownership

Proprietary

Certified

Jun 2, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

All disclosed owners & managing parties 1

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

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Tami Jane Simard, DO

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1467743864

  Home health agency

  Care Compare affiliation
• Boris Vaisman, MD

  • Specialist
  • Woodland Hills, CA
  • NPI 1508801994

  Home health agency

  Care Compare affiliation
• Kristine Vardanyan, MD

  • Internal Medicine Physician
  • Sherman Oaks, CA
  • NPI 1972023778

  Home health agency

  Care Compare affiliation
• Amir Vokshoor, M.D.

  • Neurological Surgery Physician
  • Santa Monica, CA
  • NPI 1649204983

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1083260897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 222",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447836",
            "telephone_number": "818-488-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 222",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447836",
            "telephone_number": "818-488-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL STAR PHOENIX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "VIRABYAN",
        "authorized_official_first_name": "ZARUHI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-488-9299"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.