Active NPI
Athella Home Health Inc
- Home Health Agency
- Van Nuys, CA
National Provider Identifier
1265024707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ATHELLA HOME HEALTH INC
- Practice address
- 14664 Victory Blvd Ste 102
Van Nuys, CA 91411-1621 - Phone
- (661) 388-4045
- NPI assigned
- Feb 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sargis Gadyan
- Title
- Cfo
- Phone
- (661) 388-4045
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
14664 Victory Blvd Ste 102
Van Nuys, CA 91411-1621
Mailing address
14664 Victory Blvd Ste 102
Van Nuys, CA 91411-1621
Phone (661) 388-4045
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221031000240 | CA | Part A Provider - Home Health Agency | 4385011618 | Practice locations: Valencia, CA |
Home health agency certification: CCN 757247
- Legal name
- ATHELLA HOME HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 21, 2023
- Last certification
- Feb 15, 2023
- Organization structure
- Corporation
- Incorporated
- Jan 15, 2021 in CA
- Enrollment address
- 27200 Tourney Rd
Ste 102
Valencia, CA 91355-4910
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Athella Home Health, Inc.
- Ownership
- -
- Certified
- Feb 21, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
27200 Tourney Rd
Ste 102
Valencia, CA 91355
Phone (661) 388-4045
14664 Victory Blvd
Ste 102
Van Nuys, CA 91411
Phone (661) 388-4045
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Sirazard Kyurkchyan | 5% Or Greater Direct Ownership Interest | Jan 15, 2021 | 100% |
| Corporate Officer | Jan 15, 2021 | 100% | |
| Operational/Managerial Control | Jan 15, 2021 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1043849979
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737590400000",
"number": "1265024707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14664 VICTORY BLVD STE 102",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914111621",
"telephone_number": "661-388-4045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14664 VICTORY BLVD STE 102",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914111621",
"telephone_number": "661-388-4045"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHELLA HOME HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-05",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A",
"authorized_official_last_name": "GADYAN",
"authorized_official_first_name": "SARGIS",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "661-388-4045"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.