Moonlight Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2017084 Issued in OH

Legal business name

MOONLIGHT HOME HEALTH CARE INC

Practice address

102 Javit CT
Youngstown, OH 44515-2409

Phone

(330) 990-0960

Fax

(614) 396-7411

NPI assigned

Jan 11, 2012

Last updated

Apr 28, 2025By 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

Sasi Kaza

Title

Owner

Phone

(330) 990-0960

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083984769. Details of each certification follow.

• CCN 369006 Home health agency · Active · Details

Home health agency certification: CCN 369006

Legal name

MOONLIGHT HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 19, 2013

Last certification

Feb 6, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 28, 2011 in OH

Enrollment address

102 Javit Court
Youngstown, OH 44515
HHA Branch

Listed as

Moonlight Home Health Care IncCCN 369006 · All quality measures

Ownership

Proprietary

Certified

Apr 19, 2013

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 3

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

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1083984769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 ROCHE DR STE 227",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293273",
            "telephone_number": "614-396-7345",
            "fax_number": "614-396-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 JAVIT CT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152409",
            "telephone_number": "330-990-0960",
            "fax_number": "614-396-7411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Roche Dr Ste 227",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432293273",
            "country_code": "US",
            "telephone_number": "614-396-7345",
            "fax_number": "614-396-7411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOONLIGHT HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "KAZA",
        "authorized_official_first_name": "SASI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-990-0960"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "2017084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Michael Moody, D.D.S.
• Kristy Lynn Moody, LISW
• Emily J Mook
• Marisa D Mook, LISW-S
• Fawne Moon
• Angela Moore
• Catrina Moore
• Cherie V. Moore
• Christina Lee Moore
• Christine Moore, LPN

• Home Health Agency in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.