Brockton Home Health Care Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BROCKTON HOME HEALTH CARE AGENCY

Doing business as

Brockton HHA

Practice address

71 Legion Pkwy Ste 15
Brockton, MA 02301-7225

Phone

(508) 219-0101

Fax

(508) 281-2030

NPI assigned

Nov 15, 2016

Last updated

Jan 15, 2020By 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

Mr. Pelege Marcellin, MBA

Title

Administrator

Phone

(508) 219-0101

Specialties & licenses 1

Addresses

Other names 1

• Brockton HHA Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245772730. Details of each certification follow.

• CCN 227712 Home health agency · Active · Details

Home health agency certification: CCN 227712

Legal name

BROCKTON HOME HEALTH CARE AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 30, 2018

Last certification

Mar 30, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Nov 15, 2016 in MA

Enrollment address

71 Legion Pkwy
Ste 15
Brockton, MA 02301-7225
HHA Branch

Listed as

Brockton Home Health Care AgencyCCN 227712 · All quality measures

Overall star rating

1 of 5

Ownership

Proprietary

Certified

Mar 30, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, 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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eva Bazile

  • Family Nurse Practitioner
  • West Bridgewater, MA
  • NPI 1235000480
  NPD

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1245772730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 LEGION PKWY",
            "address_2": "SUITE 15",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017225",
            "telephone_number": "508-219-0101",
            "fax_number": "508-281-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 LEGION PKWY STE 15",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017225",
            "telephone_number": "508-219-0101",
            "fax_number": "508-281-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON HOME HEALTH CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "MARCELLIN",
        "authorized_official_first_name": "PELEGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "508-219-0101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brockton HHA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Brockton, MA
• Providers in Brockton, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.