NPIMap

Organization Active NPI

Saguaro Home Health Care LLC

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1134215916
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
606HHA-10 Issued in NV
Legal business name
SAGUARO HOME HEALTH CARE LLC
Practice address
8945 W Russell Rd Ste 180
Las Vegas, NV 89148-1228
Phone
(702) 248-6850
Fax
(702) 650-3540
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Authorized official

Name
Ramon A Dimaculangan Jr.
Title
Administrator
Phone
(702) 248-6850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 606HHA-10 NV Primary

Addresses

Primary practice location

8945 W Russell Rd Ste 180
Las Vegas, NV 89148-1228

Mailing address

8945 W Russell Rd Ste 180
Las Vegas, NV 89148-1228
Phone (702) 248-6850

Other identifiers 1

IdentifierTypeStateIssuer
2902018MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL saguarox@aol.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061122000476 NV Part A Provider - Home Health Agency 0345248530 Practice locations: Las Vegas, NV

Home health agency certification: CCN 297082

Legal name
SAGUARO HOME HEALTH CARE, LLC
Doing business as
SAGUARO HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 9, 1997
Last certification
Oct 25, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 20, 2002 in NV
Enrollment address
8945 W Russell Rd
Ste 180
Las Vegas, NV 89148-1228

Care Compare: Home health agency

Medicare Care Compare
Listed as
Saguaro Home Health CareCCN 297082
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Apr 9, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
29D0944221Saguaro Home Health Care8945 W Russell Rd Ste 180, Las Vegas, NV 89148Certificate of waiverApr 8, 2028

National Provider Directory

National Provider Directory

Locations

8945 W Russell Rd
Ste 180
Las Vegas, NV 89148
Phone (702) 248-6850

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
Carina Broderick Individual Corporate DirectorDirector of Finance Nov 16, 2006
W-2 Managing EmployeeOffice Manager Nov 16, 2006
Ramon a. Dimaculangan Individual 5% Or Greater Direct Ownership InterestAdministrator Nov 16, 2006 95%
Corporate DirectorAdministrator Nov 16, 2006
W-2 Managing EmployeeAdministrator Nov 16, 2006
Reena Dimaculangan Individual 5% Or Greater Direct Ownership InterestAssistant Manager Dec 5, 2016 5%
W-2 Managing Employee Dec 5, 2016

Practitioners & affiliated clinicians

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1134215916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8945 W RUSSELL RD STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481228",
            "telephone_number": "702-248-6850",
            "fax_number": "702-650-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8945 W RUSSELL RD STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481228",
            "telephone_number": "702-248-6850",
            "fax_number": "702-650-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGUARO HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "DIMACULANGAN",
        "authorized_official_first_name": "RAMON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-248-6850",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "606HHA-10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2902018",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "saguarox@aol.com",
            "affiliation": "N",
            "endpointDescription": "Administrator email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8945 W Russell Rd Ste 180",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891481228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.