NPIMap

Organization Active NPI

LHCG Cxliii, LLC

Doing business as Geisinger Home Health

  • Home Health Agency
  • Hazle Township, PA
National Provider Identifier
1245797570
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG CXLIII, LLC
Doing business as
Geisinger Home Health
Practice address
1201B N Church St Ste 403
Hazle Township, PA 18202-1455
Phone
(570) 450-4050
Fax
(570) 450-4051
NPI assigned
Feb 22, 2019
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Secretary/Treasurer
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1201B N Church St Ste 403
Hazle Township, PA 18202-1455

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

426 Airport Rd Ste 138
Hazle Township, PA 18202-3361
Phone (570) 450-4050

Other identifiers 1

IdentifierTypeStateIssuer
1037436480001MedicaidPA

Other names 1

  • Geisinger Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190926000930 PA Part A Provider - Home Health Agency 7416287925 Practice locations: Hazle Township, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245797570. Details of each certification follow.

Home health agency certification: CCN 398030

Legal name
LHCG CXLIII, LLC
Doing business as
GEISINGER HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 7, 2005
Last certification
Aug 28, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 7, 2018 in PA
Enrollment address
1201B N Church St
Ste 403
Hazle Township, PA 18202-1455

Care Compare: Home health agency

Medicare Care Compare
Listed as
Geisinger Home HealthCCN 398030 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jul 7, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, 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
39D1038521LHCG Cxliii, LLC1201B N Church Street, Suite 403, Hazleton, PA 18202Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1201B N Church St
Ste 403
Hazle Township, PA 18202
Phone (570) 450-4050

426 Airport Rd
Ste 138
Hazle Township, PA 18202
Phone (570) 450-4050

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 75%
Alysia Sirsky Individual W-2 Managing EmployeeAd; Feb 26, 2024
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Geisinger Clinic Organization, Danville, PA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2019 25%
Wendy S Daigle Individual Corporate DirectorDirector of Licensure & Reg Affairs Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2019 75%
Pennsylvania Health Care Group Holdings LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2019 75%
Joshua Lee Proffitt Individual Corporate OfficerPresident Dec 31, 2019
Risant Health, Inc. Organization, Oakland, CA Corporation 5% Or Greater Indirect Ownership Interest Mar 31, 2024 25%
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025
Keystone Healthcare Partnership, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Apr 1, 2019 100%

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Apr 1, 2019 Change of OwnershipThis provider was the buyer Omni Home CareCCN 398030, PA, NPI 1902891195

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1245797570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201B N CHURCH ST STE 403",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021455",
            "telephone_number": "570-450-4050",
            "fax_number": "570-450-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 Airport Rd Ste 138",
            "address_purpose": "LOCATION",
            "city": "Hazle Township",
            "state": "PA",
            "postal_code": "182023361",
            "country_code": "US",
            "telephone_number": "570-450-4050",
            "fax_number": "570-450-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LHCG CXLIII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037436480001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geisinger Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Geisinger Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.