NPIMap

Organization Active NPI

Ultimate Home Care, Inc.

  • Home Health Agency
  • Hallandale Beach, FL
National Provider Identifier
1205849296
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA299992467 Issued in FL
Legal business name
ULTIMATE HOME CARE, INC.
Practice address
1250 E Hallandale Beach Blvd Ste 905
Hallandale Beach, FL 33009-4643
Phone
(954) 456-0020
Fax
(954) 456-1033
NPI assigned
Aug 14, 2006
Last updated
May 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Irina Zubok
Title
Owner
Phone
(954) 456-0020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA299992467 FL Primary

Addresses

Primary practice location

1250 E Hallandale Beach Blvd Ste 905
Hallandale Beach, FL 33009-4643

Mailing address

1250 E Hallandale Beach Blvd Ste 905
Hallandale Beach, FL 33009-4643
Phone (954) 456-0020

Other identifiers 1

IdentifierTypeStateIssuer
651520700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070518000129 FL Part A Provider - Home Health Agency 9739286287 Practice locations: Hallandale Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205849296. Details of each certification follow.

Home health agency certification: CCN 108450

Legal name
ULTIMATE HOME CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 15, 2007
Last certification
Feb 6, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 16, 2006 in FL
Enrollment address
1250 E Hallandale Beach Blvd
Ste 905
Hallandale Beach, FL 33009-4643

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ultimate Home Care, IncCCN 108450 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Aug 15, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, 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
10D1055268Ultimate Home Care Inc1250 East Hallandale Beach Blvd, Hallandale Beach, FL 33009Certificate of waiverJun 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ultimate Home Care Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1250 E Hallandale Beach Blvd
Ste 905
Hallandale Beach, FL 33009
Phone (954) 455-7745

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
Irina Zubok Individual 5% Or Greater Direct Ownership Interest Oct 1, 2006
General Partnership Interest Oct 1, 2006
Corporate Director Oct 1, 2006
W-2 Managing Employee Jan 1, 2017 100%
Ultimate Home Care, Inc. Organization, Hallandale Beach, FL For-profit Operational/Managerial Control Oct 1, 2006

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1205849296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E HALLANDALE BEACH BLVD STE 905",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094643",
            "telephone_number": "954-456-0020",
            "fax_number": "954-456-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E HALLANDALE BEACH BLVD STE 905",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094643",
            "telephone_number": "954-456-0020",
            "fax_number": "954-456-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "ZUBOK",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-456-0020"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299992467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651520700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.