Jamaica Acquisition III LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

JAMAICA ACQUISITION III LLC

Practice address

3155 Grace Ave
Bronx, NY 10469-3134

Phone

(718) 291-3500

NPI assigned

Oct 12, 2017

Organization subpart

No

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

Authorized official

Name

Pasquale Debendictis

Title

Manager / Member

Phone

(516) 422-7818

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hillside Certified Home Health Care Agency Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Home health agency certification: CCN 337262

Legal name

JAMAICA ACQUISITION III LLC

Doing business as

HILLSIDE CERTIFIED HOME CARE AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 30, 1988

Last certification

Dec 19, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 23, 2016 in NY

Enrollment address

3155 Grace Ave
Bronx, NY 10469-3134
HHA Branch

Listed as

Hillside Certified Home Care AgencyCCN 337262

Ownership

Proprietary

Certified

Nov 30, 1988

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 6

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

Owners & managing parties with NPI records 1

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

• Alexander Solovey, PT

  • Physical Therapist
  • Bronx, NY
  • NPI 1972678662

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Hillside Manor Rehabilitation and Extended Care Center, LLC

  • Home Health Agency
  • Hollis, NY
  • NPI 1790186443

  Acquired from, 2017-10-01

  CMS change of ownership

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1104337542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 GRACE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 GRACE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693134",
            "telephone_number": "718-291-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMAICA ACQUISITION III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "DEBENDICTIS",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "MANAGER / MEMBER",
        "authorized_official_telephone_number": "516-422-7818"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04057365",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Certified Home Health Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chernor Jalloh, RN
• Mohamad W Jalloh
• Abdoulie Jallow, LPN
• Aisha Jallow
• Modou Jallow
• Jamila Jamal
• PJ Javellana Jamandre, PT, DPT
• Jocelyn M Jamelo, RN
• Masheena Militar Jamelo, MSN, AGPCNP
• James J Peters

• Home Health Agency in Bronx, NY
• Providers in Bronx, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.