NPIMap

Organization Active NPI

Oso Home Care, Inc.

  • Home Infusion Agency
  • Irvine, CA
National Provider Identifier
1215966205
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
PHY 43383 Issued in CA
Legal business name
OSO HOME CARE, INC.
Practice address
17175 Gillette Ave
Irvine, CA 92614-5602
Phone
(949) 660-7126
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Dr. Randy Douglas Bohart, PHARM. D
Title
President
Phone
(949) 660-7126

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X PHY 43383 CA Primary
Specialty Pharmacy 3336S0011X PHY 43383 CA

Addresses

Primary practice location

17175 Gillette Ave
Irvine, CA 92614-5602

Mailing address

17175 Gillette Ave
Irvine, CA 92614-5602
Phone (949) 660-7126

Other identifiers 1

IdentifierTypeStateIssuer
PHA 433830OtherCAMEDI CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040420000890 CA Part A Provider - Home Health Agency 8820083579 Practice locations: Irvine, CA
O20100930013587 CA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Home Health Agency 8820083579 Practice locations: Irvine, CA
O20150804006159 CA Part B Supplier - Pharmacy 8820083579 Practice locations: Irvine, CA

Home health agency certification: CCN 058304

Legal name
OSO HOME CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 22, 2005
Last certification
Mar 28, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 16, 1984 in CA
Enrollment address
17175 Gillette Ave
Irvine, CA 92614-5602

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
Oso Home Care, IncCCN 058304
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 22, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
05D0977758Oso Home Care17175 Gillette Ave, Irvine, CA 92614Certificate of waiverSep 5, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Oso Homecare Inc17175 Gillette Ave, Irvine, CA 92614-5602(949) 660-7126 Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 3, 1998

National Provider Directory

National Provider Directory

Locations

76 Alabama St
Redlands, CA 92373

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Randy Bohart Individual 5% Or Greater Direct Ownership Interest Mar 16, 1984 100%
Operational/Managerial ControlPresident Mar 16, 1984 100%
Regina Gant Individual W-2 Managing EmployeeOffice Manager Apr 9, 1997
Pamela Ann Mizell Individual W-2 Managing EmployeeVP of Operations Dec 17, 2007

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

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

Affiliated clinicians 4

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": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1215966205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17175 GILLETTE AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145602",
            "telephone_number": "949-660-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17175 GILLETTE AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145602",
            "telephone_number": "949-660-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSO HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "BOHART",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-660-7126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "CA",
            "license": "PHY 43383",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "PHY 43383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "PHA 433830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.