Crest Home Health, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CREST HOME HEALTH, LLC

Practice address

2463 Michigan Ave
Kissimmee, FL 34744-1907

Phone

(407) 201-4687

NPI assigned

Aug 25, 2021

Organization subpart

No

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

Authorized official

Name

Jason Balajadia

Title

Manager

Phone

(407) 580-4770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 687269

Legal name

CREST HOME HEALTH, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 4, 2023

Last certification

Mar 30, 2023

Organization structure

LLCProprietary

Incorporated

Aug 20, 2021 in FL

Enrollment address

2463 Michigan Ave
Kissimmee, FL 34744-1907

Listed as

Crest Home Health LLCCCN 687269

Overall star rating

1.5 of 5

Ownership

-

Certified

Apr 4, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 3

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Realeza Balajadia, RPT

  • Physical Therapist
  • Sanford, FL
  • NPI 1922319516
  NPD
• Mario Pajarillaga Sta Maria Jr., OT

  • Occupational Therapist
  • Gotha, FL
  • NPI 1427174077
  NPD

Affiliated clinicians 7

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

• Barry Alan Cook, M.D.

  • Family Medicine Physician
  • Kissimmee, FL
  • NPI 1942287149

  Home health agency

  Care Compare affiliation
• Sharon Jennifer Ebanks, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Orlando, FL
  • NPI 1912490855

  Home health agency

  Care Compare affiliation
• Kareen Kaye Evans, APRN

  • Family Nurse Practitioner
  • Davenport, FL
  • NPI 1861202376

  Home health agency

  Care Compare affiliation
• Sudha R Ganti, M.D.

  • Internal Medicine Physician
  • Casselberry, FL
  • NPI 1093715989

  Home health agency

  Care Compare affiliation
• Amabel Tangunan Lubaton, ARNP

  • Family Nurse Practitioner
  • Casselberry, FL
  • NPI 1093241663

  Home health agency

  Care Compare affiliation
• Solange Paz Becil, APRN

  • Family Nurse Practitioner
  • Casselberry, FL
  • NPI 1437730728

  Home health agency

  Care Compare affiliation
• Javier E Tello, M.D.

  • Infectious Disease Physician
  • Winter Park, FL
  • NPI 1518917251

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1255008595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5552 OAKWORTH PL",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327737052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 MICHIGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441907",
            "telephone_number": "407-201-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "BALAJADIA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-580-4770"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Regent Crisostomo
• Samira Zoe Crispin, BSW

• Home Health Agency in Kissimmee, FL
• Providers in Kissimmee, 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 Oct 5, 2021; 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.