Five Star Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001521 Issued in CA

Legal business name

FIVE STAR HOME HEALTH, INC.

Practice address

8616 La Tijera Blvd
Suite 408
Los Angeles, CA 90045-3944

Phone

(310) 642-0026

Fax

(310) 642-9202

NPI assigned

Jun 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Nieves

Title

Owner

Phone

(310) 642-0026

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 058215

Legal name

FIVE STAR HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 28, 2003

Last certification

Dec 6, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 19, 2003 in CA

Enrollment address

8616 La Tijera Blvd
Ste 408
Los Angeles, CA 90045-3950
HHA Branch

Listed as

Five Star Home Health, IncCCN 058215

Ownership

Proprietary

Certified

Oct 28, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

All disclosed owners & managing parties 3

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.

• Amin Khorsandi, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
  • NPI 1275547390

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1124023494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD",
            "address_2": "SUITE 408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453950",
            "telephone_number": "310-642-0026",
            "fax_number": "310-642-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD",
            "address_2": "SUITE 408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453944",
            "telephone_number": "310-642-0026",
            "fax_number": "310-642-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-642-0026",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08215F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah Fitzsimmons
• Sarah Hartman Fitzsimmons, LMFT ATR-BC
• Sara Asghari Fitzwater
• Sean Patrick Fitzwater, M.D., M.H.S.
• Five Point Physical Therapy Inc
• Five Star Non-Emergency Medical Transportation
• Fixyou Ortho, LLC
• Winifred Lloyd Flach, LMFT
• Emily Frank Flack, OTR/L
• Flag Home Health Care, Inc.

• Home Health Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.