NPIMap

Organization Active NPI

Primary Homecare Specialties, LLC

  • Home Health Agency
  • Milton, MA
National Provider Identifier
1205869575
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRIMARY HOMECARE SPECIALTIES, LLC
Practice address
75 Adams St
Suite D
Milton, MA 02186-3432
Phone
(617) 696-0600
Fax
(617) 696-1200
NPI assigned
Jul 9, 2006
Last updated
Jun 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Authorized official

Name
Mrs. Celeste Cefalu, R.N.
Title
Director/Manager
Phone
(617) 930-7076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

75 Adams St
Suite D
Milton, MA 02186-3432

Mailing address

75 Adams St
Suite D
Milton, MA 02186-3432
Phone (617) 696-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060801000358 MA Part A Provider - Home Health Agency 0648283002 Practice locations: Milton, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205869575. Details of each certification follow.

Home health agency certification: CCN 227509

Legal name
PRIMARY HOMECARE SPECIALTIES, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 22, 2009
Last certification
Jun 8, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 15, 2005 in MA
Enrollment address
75 Adams St Suite D
Milton, MA 02186-3441

Care Compare: Home health agency

Medicare Care Compare
Listed as
Primary Homecare SpecialtiesCCN 227509 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 22, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory

Locations

75 Adams St
Ste D
Milton, MA 02186
Phone (617) 696-0600

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.

NameRoleSinceShare
Celeste Crescenzi Individual 5% Or Greater Direct Ownership InterestDirector Apr 21, 2009 100%
Corporate DirectorDirector Nov 15, 2005 100%
W-2 Managing EmployeeDirector Nov 15, 2005 100%

Practitioners & affiliated clinicians

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1205869575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ADAMS ST",
            "address_2": "SUITE D",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863432",
            "telephone_number": "617-696-0600",
            "fax_number": "617-696-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ADAMS ST",
            "address_2": "SUITE D",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863432",
            "telephone_number": "617-696-0600",
            "fax_number": "617-696-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HOMECARE SPECIALTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "CEFALU",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_title_or_position": "DIRECTOR/MANAGER",
        "authorized_official_telephone_number": "617-930-7076",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

Verify at the official NPI Registry.