Sda Home Health Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SDA HOME HEALTH CARE SERVICES

Practice address

1864 E Washington Blvd Ste 202
Pasadena, CA 91104-1667

Phone

(626) 817-9990

NPI assigned

May 2, 2019

Last updated

May 2, 2019By 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

Tatevik Ayvazyan

Title

Ceo

Phone

(626) 817-9990

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215592639. Details of each certification follow.

• CCN 559284 Home health agency · Active · Details

Home health agency certification: CCN 559284

Legal name

SDA HOME HEALTH CARE SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 4, 2020

Last certification

Aug 4, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Dec 22, 2018 in CA

Enrollment address

1864 E Washington Blvd
Ste 202
Pasadena, CA 91104-1667

Listed as

Sda Home Health Care ServicesCCN 559284 · All quality measures

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Aug 4, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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.

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1215592639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 E WASHINGTON BLVD STE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041667",
            "telephone_number": "626-817-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 E WASHINGTON BLVD STE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041667",
            "telephone_number": "626-817-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDA HOME HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "AYVAZYAN",
        "authorized_official_first_name": "TATEVIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-817-9990"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Scott, MA-CCC, SLP
• Sofia Scott, ACSW
• Sophia Scott
• Elizabeth Scriven
• Samuel Ashton Scudder Sr.
• Emma Seaman, AMFT
• Sean Kim, DDS, Inc.
• Lisa A Sears, P.T.
• Danielle Seckler
• Osama Sedam

• Home Health Agency in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.

Verify at the official NPI Registry.