Imhotep, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMHOTEP, INC.

Practice address

337 N Vineyard Ave
Ste #341
Ontario, CA 91764-4453

Phone

(909) 945-7087

Fax

(888) 366-0041

NPI assigned

Aug 14, 2014

Organization subpart

No

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

Authorized official

Name

Michelle Asare-Imhotep, REGISTERED NURSE

Title

President/Ceo

Phone

(909) 945-7087

Specialties & licenses 1

Addresses

Other names 1

• Presidential Care Home Health Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 553153

Legal name

IMHOTEP, INC.

Doing business as

PRESIDENTIAL CARE HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 22, 2018

Last certification

Aug 22, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 18, 2014 in CA

Enrollment address

337 N Vineyard Ave
Ste 341
Ontario, CA 91764-5657

Listed as

Presidential Care Home HealthCCN 553153

Ownership

Proprietary

Certified

Aug 22, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Imhotep Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Imhotep, Inc.

  • Community Based Hospice Care Agency
  • Victorville, CA
  • NPI 1952700932
  NPD tax ID

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

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

• Carlo Medina, M.D.

  • Internal Medicine Physician
  • Marina del Rey, CA
  • NPI 1093786444

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1134528342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 N VINEYARD AVE",
            "address_2": "STE #341",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644453",
            "telephone_number": "909-945-7087",
            "fax_number": "888-366-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 N VINEYARD AVE",
            "address_2": "STE #341",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644453",
            "telephone_number": "909-945-7087",
            "fax_number": "888-366-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMHOTEP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "ASARE-IMHOTEP",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-945-7087",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presidential Care Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Iris Ibarria
• Chiamaka Ibeabuchi
• Alejandra Ignacio Jovel
• Jordan Chase Ihrig
• Tiffany Ikera, MS, BCBA
• Regina Imperio
• Andrea Imura
• Jutzelly Moncerrat Inda
• Samantha Inda
• Yesenia Infante Fernandez

• Home Health Agency in Ontario, CA
• Providers in Ontario, 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 Mar 8, 2016; 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.