M.D. Home Health, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299992400 Issued in FL

Legal business name

M.D. HOME HEALTH, LLC

Practice address

580 Village Blvd Ste 315
West Palm Beach, FL 33409-1953

Phone

(561) 689-0445

Fax

(561) 689-0415

NPI assigned

Jun 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mario Darnell Dickerson, RN, RRT

Title

Administrator

Phone

(561) 689-0445

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 108434

Legal name

MD HOME HEALTH, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 6, 2007

Last certification

Jan 16, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

580 Village Blvd
Ste 315
West Palm Beach, FL 33409-1953

Listed as

M D Home Health LLCCCN 108434 · All quality measures

Ownership

Proprietary

Certified

Jul 6, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1235179607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 VILLAGE BLVD STE 315",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091953",
            "telephone_number": "561-689-0445",
            "fax_number": "561-689-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 VILLAGE BLVD STE 315",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091953",
            "telephone_number": "561-689-0445",
            "fax_number": "561-689-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.D. HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "DARNELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-689-0445",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, RRT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651363800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dina Macaluso, PSY.D; LMHC

• Home Health Agency in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.