Aviense Home Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AVIENSE HOME HEALTHCARE, INC

Practice address

5105 Tollview Dr Ste 180
Rolling Meadows, IL 60008-3724

Phone

(815) 230-5100

Fax

(815) 846-0841

NPI assigned

Nov 17, 2020

Last updated

Sep 5, 2024By 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

Johanna Segala

Title

President

Phone

(815) 230-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245833920. Details of each certification follow.

• CCN 148388 Home health agency · Active · Details

Home health agency certification: CCN 148388

Legal name

AVIENSE HOME HEALTHCARE, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 10, 2021

Last certification

May 10, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 6, 2020 in IL

Enrollment address

5105 Tollview Dr
Ste 180
Rolling Meadows, IL 60008-3969

Listed as

Aviense Home Healthcare IncCCN 148388 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

May 10, 2021

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 5

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

Affiliated clinicians 2

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

• Elisabeth K Cormier, MD

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1891781241

  Home health agency

  Care Compare affiliation
• Ravinderpal Singh Nandra, M.D.

  • Internal Medicine Physician
  • Plano, IL
  • NPI 1639358427

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1245833920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 TOLLVIEW DR STE 180",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083724",
            "telephone_number": "815-230-5100",
            "fax_number": "815-846-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 TOLLVIEW DR STE 180",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083724",
            "telephone_number": "815-230-5100",
            "fax_number": "815-846-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIENSE HOME HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "SEGALA",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-230-5100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "1012044",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.aviensehomehealth.com/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5105 Tollview Dr Ste 180",
            "city": "Rolling Meadows",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600083724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Stefanie M Bailey, LCPC

• Home Health Agency in Rolling Meadows, IL
• Providers in Rolling Meadows, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.