NPIMap

Organization Active NPI

Preferred Certified, LLC

  • Home Health Agency
  • Mount Vernon, NY
National Provider Identifier
1164021887
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PREFERRED CERTIFIED, LLC
Practice address
4 W Prospect Ave
Mount Vernon, NY 10550-2027
Phone
(914) 328-3733
NPI assigned
Oct 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Jaclyn Diana
Title
Administrator
Phone
(212) 356-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4 W Prospect Ave
Mount Vernon, NY 10550-2027

Mailing address

2003 Coney Island Ave
Brooklyn, NY 11223-2328
Phone (914) 328-3733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230905000661 NY Part A Provider - Home Health Agency 4981015500 Practice locations: Mount Vernon, NY

Home health agency certification: CCN 337458

Legal name
PREFERRED CERTIFIED LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 28, 2024
Last certification
Jun 28, 2024
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 22, 2017 in NY
Enrollment address
4 W Prospect Avenue
(Ground Floor)
Mount Vernon, NY 10550-2027

Care Compare: Home health agency

Medicare Care Compare
Listed as
Preferred CertifiedCCN 337458
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jun 28, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

5223 Broadway
Bronx, NY 10463
Phone (718) 473-1200

2003 Coney Island Ave
Fl 2
Brooklyn, NY 11223

4 W Prospect Ave
Mount Vernon, NY 10550
Phone (914) 328-3733

127 W 30th St
Rm 926
New York, NY 10001
Phone (914) 328-3733

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Samuel Weiss Individual 5% Or Greater Direct Ownership Interest Aug 25, 2020 50%
Shmuel Weiss Individual 5% Or Greater Direct Ownership InterestOwner Aug 25, 2020 50%
Corporate OfficerChief Financial Officer Mar 27, 2023
Arthur J Byrd Individual Corporate OfficerChief Financial Officer Dec 13, 2023 10%
Max R Lafer Individual Corporate OfficerChief Financial Officer Dec 13, 2023
W-2 Managing EmployeeChief Legal Officer Dec 13, 2023

Practitioners & affiliated clinicians

Affiliated clinicians 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1164021887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232328",
            "telephone_number": "914-328-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W PROSPECT AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502027",
            "telephone_number": "914-328-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED CERTIFIED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "DIANA",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "212-356-4200"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.