Primemed Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRIMEMED HOME HEALTH CARE, INC.

Practice address

12440 Firestone Blvd Ste 2011
Norwalk, CA 90650-4328

Phone

(562) 204-6890

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Raj AugustineNPI 1174825988

Title

Ceo

Phone

(951) 480-5030

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559340

Legal name

PRIMEMED HOME HEALTH CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 28, 2020

Last certification

Sep 28, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Dec 21, 2018 in CA

Enrollment address

8905 Glenoaks Blvd
Sun Valley, CA 91352-2086

Listed as

Primemed Home Health Care, IncCCN 559340

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Sep 28, 2020

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.

Practitioners 1

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

• Raj Augustine, PH.D.

  • Psychologist
  • Moreno Valley, CA
  • NPI 1174825988
  NPD Authorized official

Affiliated clinicians 3

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

• Mark N Gobrial, M.D.

  • Internal Medicine Physician
  • Mission Hills, CA
  • NPI 1437577343

  Home health agency

  Care Compare affiliation
• Yousef W Ireifej, M.D.

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1962693598

  Home health agency

  Care Compare affiliation
• Fariborz Shams, D.O.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1063421865

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1265996771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD STE 2011",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504328",
            "telephone_number": "562-204-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD STE 2011",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504328",
            "telephone_number": "562-204-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEMED HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-480-5030",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.