Active NPI
Moonlight Home Health Care Inc
- Home Health Agency
- Youngstown, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2017084
- 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
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2017084 | OH | Primary |
Addresses
Primary practice location
102 Javit CT
Youngstown, OH 44515-2409
Mailing address
5900 Roche Dr Ste 227
Columbus, OH 43229-3273
Phone (614) 396-7345
Other practice location 1
5900 Roche Dr Ste 227
Columbus, OH 43229-3273
Phone (614) 396-7345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120710000651 | OH | Part A Provider - Home Health Agency | 3072778463 | Practice locations: Youngstown, OH |
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
- Corporation
- Incorporated
- Apr 28, 2011 in OH
- Enrollment address
- 102 Javit Court
Youngstown, OH 44515
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Moonlight Home Health Care Inc
- Ownership
- Proprietary
- Certified
- Apr 19, 2013
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
113 S Court St
Ste 230
Circleville, OH 43113
Phone (614) 396-7345
5900 Roche Dr
Ste 227
Columbus, OH 43229
Phone (614) 396-6360
1971 W 5th Ave
Ste 3
Columbus, OH 43212
Phone (614) 481-1937
117 W Main St
Ste 202
Lancaster, OH 43130
Phone (614) 396-7345
102 Javit Ct
Youngstown, OH 44515
Phone (330) 990-0960
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Abdirahman Abdullah | W-2 Managing Employee | Dec 6, 2019 | |
| Sasi Kaza | 5% Or Greater Direct Ownership Interest | Dec 6, 2019 | 100% |
| Dana Meek | Corporate Officer | Jul 22, 2020 |
NPI Registry JSON
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": []
}
Other providers in Youngstown, OH
Sources for this page
- 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.