Active NPI
Alphacare Home Health Agency
- Home Health Agency
- North Andover, MA
National Provider Identifier
1154579076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ALPHACARE HOME HEALTH AGENCY
- Practice address
- 8 Fernview Ave
Suite 6
North Andover, MA 01845-4457 - Phone
- (978) 774-1179
- NPI assigned
- Sep 4, 2008
- Last updated
- Sep 4, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anton Pukhovitsky
- Title
- President
- Phone
- (978) 774-1179
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
8 Fernview Ave
Suite 6
North Andover, MA 01845-4457
Mailing address
8 Fernview Ave
Suite 6
North Andover, MA 01845-4457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081217000109 | MA | Part A Provider - Home Health Agency | 1355403924 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Swansea, MA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1154579076. Details of each certification follow.
Home health agency certification: CCN 227523
- Legal name
- ALPHACARE HOME HEALTH AGENCY INC
- Doing business as
- ALPHACARE HOME HEALTH AGENCY
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 8, 2010
- Last certification
- Aug 8, 2010
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Sep 10, 2008 in MA
- Enrollment address
- 1707 Gar Hwy
Swansea, MA 02777-3901
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Alphacare Home Health Agency
- Overall star rating
- Ownership
- Proprietary
- Certified
- Aug 8, 2010
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Yelena Pukhovitskaya | 5% Or Greater Direct Ownership Interest | Sep 19, 2008 | 10% |
| Corrie Lynn Asencio-Costa | 5% Or Greater Direct Ownership Interest | May 31, 2015 | 8.5% |
| Anton Pukhovitsky | 5% Or Greater Direct Ownership Interest | Feb 7, 2017 | 33% |
| Corporate Officer | Feb 7, 2017 | 33% | |
| Corporate Director | Feb 7, 2017 | 33% | |
| Kellie Ferrie | 5% Or Greater Direct Ownership Interest | Feb 7, 2017 | 15.5% |
| Corporate Director | Feb 7, 2017 | 15.5% | |
| W-2 Managing Employee | Feb 7, 2017 | 15.5% | |
| Valentina Schmidt | 5% Or Greater Direct Ownership Interest | Sep 19, 2008 | 33% |
| Corporate Director | Sep 19, 2008 | 33% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Certified Registered Nurse Anesthetist
- Fall River, MA
- NPI 1699436501
5% Or Greater Direct Ownership Interest
-
- Psychiatric/Mental Health Nurse Practitioner
- Swansea, MA
- NPI 1356819908
5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220486400000",
"number": "1154579076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 FERNVIEW AVE",
"address_2": "SUITE 6",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018454457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 FERNVIEW AVE",
"address_2": "SUITE 6",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018454457",
"telephone_number": "978-774-1179"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALPHACARE HOME HEALTH AGENCY",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-04",
"last_updated": "2008-09-04",
"status": "A",
"authorized_official_last_name": "PUKHOVITSKY",
"authorized_official_first_name": "ANTON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "978-774-1179"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.