Organization Active NPI

Sundance Home Care Inc.

  • Home Health Agency
  • Brooklyn, NY
National Provider Identifier
1245778802
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2381L001 Issued in NY
Legal business name
SUNDANCE HOME CARE INC.
Practice address
504 Livonia Ave
Brooklyn, NY 11207-5248
Phone
(347) 796-1777
Fax
(718) 514-6434
NPI assigned
Feb 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Mr. Steven Metelsky
Title
Administrator
Phone
(347) 796-1777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2381L001 NY Primary

Addresses

Primary practice location

504 Livonia Ave
Brooklyn, NY 11207-5248

Mailing address

504 Livonia Ave
Brooklyn, NY 11207-5248
Phone (347) 796-1777

Other identifiers 1

IdentifierTypeStateIssuer
04708930MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Sundance Home Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1245778802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075248",
            "telephone_number": "347-796-1777",
            "fax_number": "718-514-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075248",
            "telephone_number": "347-796-1777",
            "fax_number": "718-514-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE HOME CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "METELSKY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "347-796-1777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "2381L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04708930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.