Active NPI
A&K Home Health, Inc.
- Home Health Agency
- Glendale, CA
National Provider Identifier
1154885671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- A&K HOME HEALTH, INC.
- Practice address
- 225 W Broadway Ste 115
Glendale, CA 91204-5108 - Phone
- (818) 696-6010
- NPI assigned
- Jan 29, 2019
- 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
- Anna Petrosyan
- Title
- Ceo
- Phone
- (818) 696-6010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
225 W Broadway Ste 115
Glendale, CA 91204-5108
Mailing address
225 W Broadway Ste 115
Glendale, CA 91204-5108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200303001862 | CA | Part A Provider - Home Health Agency | 2163859190 | Practice locations: Glendale, CA |
Home health agency certification: CCN 559230
- Legal name
- A&K HOME HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 22, 2020
- Last certification
- Apr 22, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Enrollment address
- 225 W Broadway
Ste 115
Glendale, CA 91204-5108
Care Compare: Home health agency
Medicare Care Compare- Listed as
- A&K Home Health, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 22, 2020
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2188506 | A&K Home Health, Inc | Certificate of waiver | Jul 16, 2026 |
National Provider Directory
National Provider DirectoryLocations
225 W Broadway
Ste 115
Glendale, CA 91204
Phone (818) 696-6010
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Anna Petrosyan | 5% Or Greater Direct Ownership Interest | Dec 3, 2018 | 100% |
| Corporate Officer | Nov 8, 2019 | 100% | |
| Corporate Director | Nov 18, 2019 | 100% | |
| W-2 Managing Employee | Nov 8, 2019 | 100% |
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": "1548720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1548720000000",
"number": "1154885671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 W BROADWAY STE 115",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912045108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 W BROADWAY STE 115",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912045108",
"telephone_number": "818-696-6010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "A&K HOME HEALTH, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-29",
"last_updated": "2019-01-29",
"status": "A",
"authorized_official_last_name": "PETROSYAN",
"authorized_official_first_name": "ANNA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "818-696-6010"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.