Dominion Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DOMINION HEALTHCARE LLC

Practice address

925 Washington St
Suite 5
Dorchester, MA 02124-4647

Phone

(617) 230-7118

NPI assigned

Aug 11, 2014

Last updated

Mar 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jane Mercy Okundaye

Title

Ceo

Phone

(617) 230-7118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174932529. Details of each certification follow.

• CCN 227669 Home health agency · Active · Details

Home health agency certification: CCN 227669

Legal name

DOMINION HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 16, 2016

Last certification

Jun 16, 2016

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

1044 Central St
Ste 104
Stoughton, MA 02072-4423
HHA Branch

Listed as

Dominion Healthcare, LLCCCN 227669 · All quality measures

Ownership

Proprietary

Certified

Jun 16, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, 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

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.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ariana Caitlin Belsky, PT, DPT

  • Physical Therapist
  • Boston, MA
  • NPI 1003421348
  NPD (past)
• Leah Gillespie, DPT

  • Physical Therapist
  • Stoughton, MA
  • NPI 1164771309
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1174932529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 WASHINGTON ST",
            "address_2": "SUITE 5",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021244647",
            "telephone_number": "617-230-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 WASHINGTON ST",
            "address_2": "SUITE 5",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021244647",
            "telephone_number": "617-230-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "OKUNDAYE",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "MERCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-230-7118"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.