Guardian Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GUARDIAN HEALTHCARE, LLC

Practice address

891 Centre St
Jamaica Plain, MA 02130-2776

Phone

(617) 477-8290

Fax

(888) 333-1164

NPI assigned

Oct 6, 2008

Organization subpart

No

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

Authorized official

Name

Jose A De la Rosa

Title

Ceo

Phone

(617) 477-8290

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Home health agency certification: CCN 227516

Legal name

GUARDIAN HEALTHCARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 26, 2010

Last certification

Feb 26, 2010

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Sep 4, 2008 in MA

Enrollment address

891 Centre St
Jamaica Plain, MA 02130-2776
HHA Branch

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Family Caregivers

  • Foster Care Agency
  • Jamaica Plain, MA
  • NPI 1861730715

  O20091007000648

  Same enrollment

Listed as

Guardian HealthcareCCN 227516

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Feb 26, 2010

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 2

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

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.

• Family Caregivers

  • Foster Care Agency
  • Jamaica Plain, MA
  • NPI 1861730715
  NPPES parent name

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1265683569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 CENTRE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-477-8290",
            "fax_number": "617-477-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302776",
            "telephone_number": "617-477-8290",
            "fax_number": "888-333-1164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Marston St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018412358",
            "country_code": "US",
            "telephone_number": "978-975-2000",
            "fax_number": "888-333-1164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Belmont St Ste 209",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023014435",
            "country_code": "US",
            "telephone_number": "508-562-4009",
            "fax_number": "508-408-0284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 Boston Tpke Ste 303",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015453415",
            "country_code": "US",
            "telephone_number": "508-925-4800",
            "fax_number": "508-342-5664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GUARDIAN HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "DE LA ROSA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-477-8290"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085134E",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085134C",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Grinnell
• Latiaya Lanee Grooms, BA
• Anthony Philip Gross, AGACNP-BC, CNP, RN
• Jacqueline Gross
• Lisa Marie Grossi, RN, MS, CPNP
• Ariane Guasconi, LICSW
• Alexandra M Gudlevich, MOT, OTR/L
• Maneesha Gulati, MSW
• Suzy Bird Gulliver, PH.D.
• Thomas Edward Gunnoud III

• Home Health Agency in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.