Organization Active NPI

Ethio Home Health Care LLC

  • Home Health Agency
  • Cambridge, MA
National Provider Identifier
1114386901
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ETHIO HOME HEALTH CARE LLC
Practice address
545 Concord Ave
Ste 6
Cambridge, MA 02138-1125
Phone
(617) 955-0629
NPI assigned
Feb 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Authorized official

Name
Samson Haileyesus
Title
Owner
Phone
(617) 320-2382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

545 Concord Ave
Ste 6
Cambridge, MA 02138-1125

Mailing address

545 Concord Ave
Ste 6
Cambridge, MA 02138-1125
Phone (617) 955-0629

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
22D2117167Ethio Home Health Care LLC545 Concord Ave Ste 6, Cambridge, MA 02138Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

545 Concord Ave
Ste 6
Cambridge, MA 02138
Phone (617) 955-0629

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456099200000",
    "number": "1114386901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 CONCORD AVE",
            "address_2": "STE 6",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381125",
            "telephone_number": "617-955-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 CONCORD AVE",
            "address_2": "STE 6",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381125",
            "telephone_number": "617-955-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHIO HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A",
        "authorized_official_last_name": "HAILEYESUS",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-320-2382"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.