Active NPI
Marys Home Health Care, Inc
- Home Health Agency
- Glendale, CA
National Provider Identifier
1093391294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- MARYS HOME HEALTH CARE, INC
- Practice address
- 127 S Brand Blvd Ste 210
Glendale, CA 91204-1372 - Phone
- (747) 737-3028
- NPI assigned
- Mar 19, 2021
- Last updated
- Mar 19, 2021
- 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
- Mary Teradamyan
- Title
- Ceo
- Phone
- (747) 737-3028
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
127 S Brand Blvd Ste 210
Glendale, CA 91204-1372
Mailing address
127 S Brand Blvd Ste 210
Glendale, CA 91204-1372
Phone (747) 737-3028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230925002392 | CA | Part A Provider - Home Health Agency | 8921452913 | Practice locations: Glendale, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1093391294. Details of each certification follow.
Home health agency certification: CCN 757698
- Legal name
- MARYS HOME HEALTH CARE, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 12, 2024
- Last certification
- Jul 12, 2024
- Organization structure
- Corporation
- Incorporated
- Feb 22, 2021 in CA
- Enrollment address
- 127 S Brand Blvd
Ste 210
Glendale, CA 91204-1372
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Mary's Home Health Care, Inc.
- Ownership
- -
- Certified
- Jul 12, 2024
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
127 S Brand Blvd
Ste 210
Glendale, CA 91204
Phone (747) 737-3028
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Mary M Teradamyan | 5% Or Greater Direct Ownership Interest | Feb 22, 2021 | 100% |
| Corporate Officer | Feb 22, 2021 | 100% | |
| Corporate Director | Feb 22, 2021 | 100% | |
| W-2 Managing Employee | Feb 22, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Pulmonary Disease Physician
- Santa Monica, CA
- NPI 1699790584
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616112000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616112000000",
"number": "1093391294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 S BRAND BLVD STE 210",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912041372",
"telephone_number": "747-737-3028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 S BRAND BLVD STE 210",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912041372",
"telephone_number": "747-737-3028"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYS HOME HEALTH CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-19",
"last_updated": "2021-03-19",
"certification_date": "2021-03-19",
"status": "A",
"authorized_official_last_name": "TERADAMYAN",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "747-737-3028"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.