Supreme Care Group

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPREME CARE GROUP

Practice address

15455 San Fernando Mission Blvd Ste 103B
Mission Hills, CA 91345-1342

Phone

(818) 967-9255

Fax

(818) 301-2384

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Oganes Samsonyan

Title

Ceo

Phone

(818) 357-8558

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 753115

Legal name

SUPREME CARE GROUP

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 12, 2022

Last certification

Apr 12, 2022

Organization structure

CorporationProprietary

Incorporated

May 23, 2018 in CA

Enrollment address

6005 Vineland Ave
Ste 211
North Hollywood, CA 91606-4982

Listed as

Supreme Care GroupCCN 753115

Overall star rating

3.5 of 5

Ownership

-

Certified

Apr 12, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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.

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1275008443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15455 SAN FERNANDO MISSION BLVD STE 103B",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451342",
            "telephone_number": "818-357-8558",
            "fax_number": "818-301-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 SAN FERNANDO MISSION BLVD STE 103B",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451342",
            "telephone_number": "818-967-9255",
            "fax_number": "818-301-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "SAMSONYAN",
        "authorized_official_first_name": "OGANES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-357-8558"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Suazo, DPT, PT
• Dennis T. Sugiyama, O. D.
• Yoojin Suh, FNP
• Fidelis M Sumampong, N.P.
• Sunshine Health and Wellness LLC
• Arshia S Surti, M.D.
• Sourabh Suryadevara, M.D.
• Paul Sussman, MD.
• Pharnuk Suthipinijtham, DO.
• Richard G Swanberg, M.D.

• Home Health Agency in Mission Hills, CA
• Providers in Mission Hills, 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 Feb 23, 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.