NPIMap

Organization Active NPI

Regency Home Health Care, P.C.

  • Home Health Agency
  • Oak Lawn, IL
National Provider Identifier
1093741415
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010758 Issued in IL
Legal business name
REGENCY HOME HEALTH CARE, P.C.
Practice address
10448 S Pulaski Rd
Suite 4
Oak Lawn, IL 60453-4895
Phone
(708) 952-1052
Fax
(708) 952-1053
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Authorized official

Name
Ahmed Mohamed, P.T.
Title
Administrator
Phone
(708) 398-4022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 070-007492 IL
Home Health Agency 251E00000X 1010758 IL Primary

Addresses

Primary practice location

10448 S Pulaski Rd
Suite 4
Oak Lawn, IL 60453-4895

Mailing address

6060 W. 95TH Street
Oak Lawn, IL 60453-2778
Phone (708) 398-4022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000688 IL Part A Provider - Home Health Agency 1355426198 Practice locations: Oak Lawn, IL

Home health agency certification: CCN 148032

Legal name
REGENCY HOME HEALTH CARE, P.C.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 30, 2008
Last certification
Dec 30, 2008
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 30, 2006 in IL
Enrollment address
6060W 95TH St
Oak Lawn, IL 60453-2778

Care Compare: Home health agency

Medicare Care Compare
Listed as
Regency Home Health Care, P CCCN 148032 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Dec 30, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1067357Regency Home Health Care P C6060 W 95TH St, Oak Lawn, IL 60453Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory

Locations

6060 W 95th St
Oak Lawn, IL 60453
Phone (708) 952-1052

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Sandra Gliva Individual Corporate DirectorDirector of Nursing Oct 23, 2017
Sayed H Yousef Individual 5% Or Greater Direct Ownership InterestAdministrator Sep 26, 2007
Corporate Officer Sep 26, 2007
Corporate Director Sep 26, 2007
W-2 Managing Employee Jul 7, 2014
Moatzz Mohamed Individual 5% Or Greater Direct Ownership Interest Feb 20, 2008
Corporate Director Feb 20, 2008
Khaled Gad Individual 5% Or Greater Direct Ownership Interest Sep 26, 2007

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Moatzz Mohamed
    • Physical Therapist
    • Chicago, IL
    • NPI 1184754798

    5% Or Greater Direct Ownership Interest, Corporate Director

    CMS ownership
  • Sayed Yousef, PT
    • Physical Therapist
    • Chicago, IL
    • NPI 1780780338

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership
  • Khaled Gad
    • Physical Therapist
    • Hammond, IN
    • NPI 1285764878

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1093741415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 W. 95TH STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532778",
            "telephone_number": "708-398-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10448 S PULASKI RD",
            "address_2": "SUITE 4",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534895",
            "telephone_number": "708-952-1052",
            "fax_number": "708-952-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY HOME HEALTH CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-398-4022",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "070-007492",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.