Organization Active NPI

Impetus Home Health Care

  • Home Health Agency
  • Pasadena, CA
National Provider Identifier
1104401926
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IMPETUS HOME HEALTH CARE
Practice address
133 N Altadena Dr Ste 309
Pasadena, CA 91107-7341
Phone
(626) 399-5716
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Karine Nagapetian
Title
President/Ceo, Secretary
Phone
(626) 314-3699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

133 N Altadena Dr Ste 309
Pasadena, CA 91107-7341

Mailing address

133 N Altadena Dr Ste 309
Pasadena, CA 91107-7341
Phone (626) 399-5716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220401002015 CA Part A Provider - Home Health Agency 9830585785 Practice locations: Pasadena, CA

Home health agency certification: CCN 757170

Legal name
IMPETUS HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 3, 2022
Last certification
Jul 22, 2022
Organization structure
CorporationProprietary
Incorporated
Jan 27, 2021 in CA
Enrollment address
133 N Altadena Dr
Ste 309
Pasadena, CA 91107-7341

Care Compare: Home health agency

Medicare Care Compare
Listed as
Impetus Home Health CareCCN 757170
Ownership
-
Certified
Aug 3, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

133 N Altadena Dr
Ste 309
Pasadena, CA 91107
Phone (626) 314-3699

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Karine Nagapetian Individual 5% Or Greater Direct Ownership InterestPresident,Ceo/Cfo,Secretary Jan 27, 2021 100%
Corporate OfficerPresident,Ceo/Cfo,Secretary Jan 27, 2021 100%
Operational/Managerial ControlPresident,/Ceo/Cfo, Seretary Jan 27, 2021 100%
Prince Robel Garcia Individual Operational/Managerial Control Oct 1, 2025

Practitioners & affiliated clinicians

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": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1104401926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N ALTADENA DR STE 309",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911077341",
            "telephone_number": "626-399-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 N ALTADENA DR STE 309",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911077341",
            "telephone_number": "626-399-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPETUS HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "NAGAPETIAN",
        "authorized_official_first_name": "KARINE",
        "authorized_official_title_or_position": "PRESIDENT/CEO, SECRETARY",
        "authorized_official_telephone_number": "626-314-3699"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.