NPIMap

Organization Active NPI

Magic Home Care LLC

  • Home Health Agency
  • Farmington Hills, MI
National Provider Identifier
1104543966
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAGIC HOME CARE LLC
Practice address
32910 W 13 Mile Rd Ste A102C
Farmington Hills, MI 48334-1980
Phone
(248) 256-5054
Fax
(248) 430-8886
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Ella Maryakhin, RN
Title
Administrator
Phone
(248) 622-6760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

32910 W 13 Mile Rd Ste A102C
Farmington Hills, MI 48334-1980

Mailing address

32910 W 13 Mile Rd Ste A102C
Farmington Hills, MI 48334-1980
Phone (248) 256-5054

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Synergy Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201003113 MI Part A Provider - Home Health Agency 4981072543 Practice locations: Farmington Hills, MI

Home health agency certification: CCN 239311

Legal name
MAGIC HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 19, 2015
Last certification
Oct 19, 2015
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 5, 2022 in MI
Enrollment address
32910 W 13 Mile Rd
Ste A102C
Farmington Hills, MI 48334-1980

Care Compare: Home health agency

Medicare Care Compare
Listed as
Magic Home Care, LLCCCN 239311 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Oct 19, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

32910 W 13 Mile Rd
Ste A102C
Farmington Hills, MI 48334
Phone (248) 256-5054

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
Ella L Maryakhin Individual 5% Or Greater Direct Ownership Interest Oct 24, 2022 66%
Corporate OfficerAdministrator, President, Board Oct 24, 2022 66%
Corporate DirectorAdministrator, President, Board Oct 24, 2022 66%
W-2 Managing EmployeeAdministrator, President, Board Oct 24, 2022 66%
Operational/Managerial ControlAdministrator, President, Board Oct 24, 2022 66%
Irina Oleynik Individual 5% Or Greater Direct Ownership Interest Oct 24, 2022 30%
Corporate OfficerVice President, Board Member, DO Oct 24, 2022 30%
Corporate DirectorVice President, Board Member, DO Oct 24, 2022 30%
W-2 Managing EmployeeVice President, Board Member, DO Oct 24, 2022 30%
Operational/Managerial ControlVice President, Board Member, DO Oct 24, 2022 30%

Change-of-ownership history 1

DateEventCounterparty
Oct 24, 2022 Change of OwnershipThis provider was the buyer Community Health and Comfort Care IncCCN 239311, MI, NPI 1689067217

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1104543966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32910 W 13 MILE RD STE A102C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341980",
            "telephone_number": "248-256-5054",
            "fax_number": "248-430-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32910 W 13 MILE RD STE A102C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341980",
            "telephone_number": "248-256-5054",
            "fax_number": "248-430-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A",
        "authorized_official_last_name": "MARYAKHIN",
        "authorized_official_first_name": "ELLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-622-6760",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Synergy",
            "affiliation": "N",
            "endpointDescription": "EMR Software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "32910 W 13 Mile Rd Ste A102C",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483341980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.