Lifestar Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIFESTAR HOME HEALTH INC

Practice address

6320 Van Nuys Blvd Ste 310
Van Nuys, CA 91401-2617

Phone

(818) 582-8068

NPI assigned

Nov 28, 2018

Last updated

Jun 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Feodor Boev

Title

Ceo

Phone

(818) 582-8068

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285104570. Details of each certification follow.

• CCN 559375 Home health agency · Active · Details

Home health agency certification: CCN 559375

Legal name

LIFESTAR HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 14, 2020

Last certification

Sep 14, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 18, 2018 in CA

Enrollment address

6320 Van Nuys Blvd
Ste 310
Van Nuys, CA 91401-2617

Listed as

Lifestar Home Health IncCCN 559375 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Sep 14, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

Affiliated clinicians 1

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

• Mohsen M Hamza, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Los Angeles, CA
  • NPI 1003996844

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1285104570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 VAN NUYS BLVD STE 310",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 VAN NUYS BLVD STE 310",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012617",
            "telephone_number": "818-582-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAR HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "BOEV",
        "authorized_official_first_name": "FEODOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-582-8068"
    },
    "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 Van Nuys, CA
• Providers in Van Nuys, 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 Jun 27, 2022; 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.