Active NPI
Supreme Home Care Agency of Ny Inc
Doing business as NU Home Care
- Home Health Agency
- Flushing, NY
National Provider Identifier
1275076580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1935L001
- Legal business name
- SUPREME HOME CARE AGENCY OF NY INC
- Doing business as
- NU Home Care
- Practice address
- 15405 Northern Blvd FL 3
Flushing, NY 11354-6724 - Phone
- (718) 888-0855
- Fax
- (718) 353-9212
- NPI assigned
- Nov 18, 2016
- Last updated
- Sep 5, 2025
- 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
- Youngsoon Lee
- Title
- Ceo
- Phone
- (718) 888-0855
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1935L001 | NY | Primary |
Addresses
Primary practice location
15405 Northern Blvd FL 3
Flushing, NY 11354-6724
Mailing address
15405 Northern Blvd FL 3
Flushing, NY 11354-6724
Phone (718) 888-0855
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04505657 | Medicaid | NY |
Other names 1
- NU Home Care
National Provider Directory
National Provider Directory- Tax ID family
- Nu Home Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
15405 Northern Blvd
Fl 3
Flushing, NY 11354
Phone (718) 888-0855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757030400000",
"number": "1275076580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15405 NORTHERN BLVD FL 3",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546724",
"telephone_number": "718-888-0855",
"fax_number": "718-353-9212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15405 NORTHERN BLVD FL 3",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546724",
"telephone_number": "718-888-0855",
"fax_number": "718-353-9212"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME HOME CARE AGENCY OF NY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-18",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "YOUNGSOON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "718-888-0855"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NY",
"license": "1935L001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04505657",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "NU Home Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "NU Home Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.