Vividus Home Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VIVIDUS HOME CARE, INC

Practice address

15643 Sherman Way Ste 430
Van Nuys, CA 91406-4185

Phone

(818) 698-0657

Fax

(818) 698-1583

NPI assigned

Nov 14, 2021

Organization subpart

No

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

Authorized official

Name

Valida Guliyeva

Title

Ceo

Phone

(818) 698-0657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757334

Legal name

VIVIDUS HOME CARE, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 4, 2023

Last certification

Jul 11, 2023

Organization structure

CorporationProprietary

Incorporated

Sep 9, 2021 in CA

Enrollment address

15643 Sherman Way
Ste 430
Van Nuys, CA 91406-4185
HHA Branch

Listed as

Vividus Home Care IncCCN 757334

Overall star rating

3.5 of 5

Ownership

-

Certified

Aug 4, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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.

Affiliated clinicians 1

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

• Gor Agababian, M.D.

  • General Practice Physician
  • Glendale, CA
  • NPI 1063442143

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636848000000",
    "number": "1215693221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15643 SHERMAN WAY STE 430",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064185",
            "telephone_number": "818-698-0657",
            "fax_number": "818-698-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15643 SHERMAN WAY STE 430",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064185",
            "telephone_number": "818-698-0657",
            "fax_number": "818-698-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIDUS HOME CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A",
        "authorized_official_last_name": "GULIYEVA",
        "authorized_official_first_name": "VALIDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-698-0657"
    },
    "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 Van Nuys, CA
• Providers in Van Nuys, 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 Nov 14, 2021; 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.