NPIMap

Organization Active NPI

Grace Community Home Health Inc

  • Home Health Agency
  • Mountain View, CA
National Provider Identifier
1154750867
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GRACE COMMUNITY HOME HEALTH INC
Practice address
229 Polaris Ave Ste 5
Mountain View, CA 94043-4579
Phone
(650) 784-0082
Fax
(650) 564-0082
NPI assigned
Nov 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Authorized official

Name
Dr. Albert Lam, M.D.NPI 1205995941
Title
Medical Director
Phone
(650) 784-0082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

229 Polaris Ave Ste 5
Mountain View, CA 94043-4579

Mailing address

229 Polaris Ave Ste 5
Mountain View, CA 94043-4579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140716000028 CA Part A Provider - Home Health Agency 4880819440 Practice locations: Mountain View, CA
O20201222000807 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4880819440 Receives reassigned benefits from 4 practitioners
Practice locations: Mountain View, CA

Home health agency certification: CCN 059656

Legal name
GRACE COMMUNITY HOME HEALTH, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 14, 2015
Last certification
Jun 14, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 1, 2013 in CA
Enrollment address
229 Polaris Ave
Ste 5
Mountain View, CA 94043-4579
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Grace Community Home Health Inc.CCN 059656
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jul 14, 2015
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
05D2080699Grace Community Home Health, Inc.229 Polaris Ave Ste 5, Mountain View, CA 94043Certificate of waiverJul 13, 2028

National Provider Directory

National Provider Directory

Locations

229 Polaris Ave
Ste 5
Mountain View, CA 94043
Phone (650) 784-0082

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Rodica Stoltzfus Individual 5% Or Greater Direct Ownership Interest Sep 1, 2013 28.5%
Corporate OfficerCoo/Administrator Sep 1, 2013 28.5%
Operational/Managerial ControlAdministrator/DPCS Sep 1, 2013 28.5%
Albert Lam Individual 5% Or Greater Direct Ownership Interest Sep 1, 2013 68.5%
Corporate OfficerCeo President Sep 1, 2013 68.5%
Operational/Managerial ControlMedical Director Sep 1, 2013 68.5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Albert Lam, MD
    • Internal Medicine Physician
    • Palo Alto, CA
    • NPI 1205995941

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 7

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": "1383436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1154750867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 POLARIS AVE STE 5",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940434579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 POLARIS AVE STE 5",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940434579",
            "telephone_number": "650-784-0082",
            "fax_number": "650-564-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-03",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-784-0082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.