NPIMap

Organization Active NPI

Tri-Borough Certified Health Systems of New York. LLC

  • Home Health Agency
  • Hempstead, NY
National Provider Identifier
1114266962
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRI-BOROUGH CERTIFIED HEALTH SYSTEMS OF NEW YORK. LLC
Practice address
50 Clinton St Ste 601
Hempstead, NY 11550-4282
Phone
(516) 932-7799
Fax
(516) 932-1415
NPI assigned
Feb 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Mr. Kenrick Cort
Title
Ceo/President/Owner
Phone
(718) 282-7619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NY Primary

Addresses

Primary practice location

50 Clinton St Ste 601
Hempstead, NY 11550-4282

Mailing address

50 Clinton St Ste 601
Hempstead, NY 11550-4282
Phone (516) 932-7799

Other identifiers 2

IdentifierTypeStateIssuer
01053983MedicaidNY
01659690MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130719000026 NY Part A Provider - Home Health Agency 1557502408 Practice locations: Hempstead, NY

Home health agency certification: CCN 337237

Legal name
TRI-BOROUGH CERTIFIED HEALTH SYSTEMS OF NEW YORK. LLC
Doing business as
FAMILY CARE CERTIFIED SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 5, 1987
Last certification
Mar 22, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 7, 2011 in NY
Enrollment address
50 Clinton St
Ste 601
Hempstead, NY 11550-4282
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Family Care Certified Services (Hempstead)CCN 337237
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Oct 5, 1987
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
Tax ID family
Family Care Certified Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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
Kenrick Cort Individual 5% Or Greater Direct Ownership Interest Nov 7, 2011 100%
Corporate OfficerSole Member & Manager, Owner Nov 7, 2011 100%
Operational/Managerial ControlPresident, Owner, Sole Member& Man Nov 7, 2011 100%
Joycelyn P Wills Individual Corporate Officer Jul 15, 2013
W-2 Managing EmployeeAssistant Vice President Nov 7, 2011

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1114266962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CLINTON ST STE 601",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504282",
            "telephone_number": "516-932-7799",
            "fax_number": "516-932-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CLINTON ST STE 601",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504282",
            "telephone_number": "516-932-7799",
            "fax_number": "516-932-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-BOROUGH CERTIFIED HEALTH SYSTEMS OF NEW YORK. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "CORT",
        "authorized_official_first_name": "KENRICK",
        "authorized_official_title_or_position": "CEO/PRESIDENT/OWNER",
        "authorized_official_telephone_number": "718-282-7619",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01053983",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01659690",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.