Organization Active NPI

Bright Blue Home Health Care Inc

  • Home Health Agency
  • Burbank, CA
National Provider Identifier
1124753207
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BRIGHT BLUE HOME HEALTH CARE INC
Practice address
1907 W Burbank Blvd Ste a
Burbank, CA 91506-1316
Phone
(747) 244-8816
Fax
(747) 241-8834
NPI assigned
Jul 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Nooshin Khani
Title
Cfo
Phone
(747) 241-8816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1907 W Burbank Blvd Ste a
Burbank, CA 91506-1316

Mailing address

1907 W Burbank Blvd Ste a
Burbank, CA 91506-1316
Phone (747) 241-8816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322000645 CA Part A Provider - Home Health Agency 6507203817 Practice locations: Burbank, CA

Home health agency certification: CCN 757847

Legal name
BRIGHT BLUE HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 7, 2025
Last certification
Jan 7, 2025
Organization structure
CorporationProprietary
Enrollment address
1907 W Burbank Blvd
Ste a
Burbank, CA 91506-1316

Care Compare: Home health agency

Medicare Care Compare
Listed as
Bright Blue Home Health Care IncCCN 757847
Ownership
-
Certified
Jan 7, 2025
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1907 W Burbank Blvd
#A
Burbank, CA 91506
Phone (747) 244-8816

Ownership & related parties

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.

NameRoleSinceShare
Nooshin Khani Individual 5% Or Greater Direct Ownership InterestCfo Jun 16, 2022 50%
Corporate OfficerCfo Jun 16, 2022 50%
W-2 Managing EmployeeCfo Jun 16, 2022 50%
Harout Derghazarian Individual 5% Or Greater Direct Ownership InterestCeo Jun 16, 2022 50%
Corporate OfficerCeo Jun 16, 2022 50%
Corporate DirectorCeo Jun 16, 2022 50%
W-2 Managing Employee Jun 16, 2022 50%
Gohar Hakobyan Individual W-2 Managing EmployeeAd;DPCS Apr 1, 2026

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1124753207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W BURBANK BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061316",
            "telephone_number": "747-241-8816",
            "fax_number": "747-241-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W BURBANK BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061316",
            "telephone_number": "747-244-8816",
            "fax_number": "747-241-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT BLUE HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "KHANI",
        "authorized_official_first_name": "NOOSHIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "747-241-8816"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.